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The Use of Volumetric Capnography in Optimizing Mechanical Ventilation Donna Hamel, RRT, RCP, FAARC Pediatric Critical Care Medicine Duke Children’s Hospital Durham, N.C.
Introduction ,[object Object],[object Object],[object Object]
Introduction ,[object Object],[object Object],[object Object],[object Object],[object Object]
What is volumetric capnography? ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
What is VCO 2 ,[object Object],[object Object],[object Object]
What is VCO 2 ,[object Object],[object Object],[object Object],[object Object]
SBCO 2  Waveform Expired CO 2 V T
SBCO 2  Waveform Expired CO 2 I V T Phase I = large airway ventilation
SBCO 2  Waveform Expired CO 2 I II V T Phase II  = mixed large airway and alveolar ventilation Phase I = large airway ventilation
SBCO 2  Waveform Expired CO 2 I II V T Phase II  = mixed large airway and alveolar ventilation Phase I  = large airway ventilation III Phase III  = exhaled volume of alveolar gas
Phases of SBCO 2  waveform ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Clinical significance ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Phase 1 assessment ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
↑  phase 1 ,[object Object],[object Object]
Phase 2 assessment ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
   Phase 2 ,[object Object]
Phase 3 assessment ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
↑  or absent phase 3 ,[object Object],[object Object]
Optimizing PEEP VCO 2  & SBCO 2 ,[object Object],[object Object],[object Object]
Slope 1: anatomic deadspace ,[object Object],[object Object],[object Object]
↑  Phase 1
Slope 2: pulmonary perfusion ,[object Object],[object Object],[object Object],[object Object]
Slope 2: pulmonary perfusion ,[object Object],[object Object],[object Object]
   Phase 2 Decreased Perfusion Baseline
Slope 3: gas distribution ,[object Object],[object Object],[object Object]
Mal-distribution of gas ,[object Object],[object Object],[object Object]
↑ Phase 3 CO 2 Exhaled Volume increased phase 3
PEEP determination ,[object Object],[object Object],[object Object],[object Object],[object Object]
PEEP determination ,[object Object],[object Object],[object Object]
What is volumetric capnography? ,[object Object],[object Object],[object Object]
Why VCO 2 ? ,[object Object],[object Object],[object Object],[object Object]
Conclusion ,[object Object],[object Object],[object Object]
Thank You!

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04 capnography hamel

  • 1. The Use of Volumetric Capnography in Optimizing Mechanical Ventilation Donna Hamel, RRT, RCP, FAARC Pediatric Critical Care Medicine Duke Children’s Hospital Durham, N.C.
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  • 7. SBCO 2 Waveform Expired CO 2 V T
  • 8. SBCO 2 Waveform Expired CO 2 I V T Phase I = large airway ventilation
  • 9. SBCO 2 Waveform Expired CO 2 I II V T Phase II = mixed large airway and alveolar ventilation Phase I = large airway ventilation
  • 10. SBCO 2 Waveform Expired CO 2 I II V T Phase II = mixed large airway and alveolar ventilation Phase I = large airway ventilation III Phase III = exhaled volume of alveolar gas
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  • 24. Phase 2 Decreased Perfusion Baseline
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  • 27. ↑ Phase 3 CO 2 Exhaled Volume increased phase 3
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