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Apollo Volume AF | 07/2010 1 | 4 Volume AF Mode Presentation: Target Volume Precise Volume Delivery Periop Advanced Ventilation

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Page 1: Target Volume Precise Volume Delivery Periop Advanced ...aacpma.com/Equipment/Draeger/Apollo/pdf's/Apollo Vol AF Mode... · 1 | 4 Apollo Volume AF | 07/2010 Volume AF Mode Presentation:

Apollo Volume AF | 07/20101 | 4

Volume AF ModePresentation:

• Target Volume

• Precise Volume Delivery

• Periop Advanced Ventilation

Page 2: Target Volume Precise Volume Delivery Periop Advanced ...aacpma.com/Equipment/Draeger/Apollo/pdf's/Apollo Vol AF Mode... · 1 | 4 Apollo Volume AF | 07/2010 Volume AF Mode Presentation:

Apollo Volume AF | 07/20102 | 4

Apollo: Volume AF ModeOutline

Traditional Modes of Ventilation Characteristics- Volume Control- Pressure Control

Curves- Pressure- Flow

Mechanical Ventilation Challenges in the Operating Room- Surgical Intervention- Patient Positioning- Gravity

Advanced Ventilation Mode- Volume Autoflow (Vol AF)- Vol AF Sync PS

Tailor Parameters- Trigger- Slope

Page 3: Target Volume Precise Volume Delivery Periop Advanced ...aacpma.com/Equipment/Draeger/Apollo/pdf's/Apollo Vol AF Mode... · 1 | 4 Apollo Volume AF | 07/2010 Volume AF Mode Presentation:

Apollo Volume AF | 07/20103 | 4

Apollo: Volume AF ModeTraditional Mechanical Ventilation Characteristics

Volume Control (VCV)

Pre-set Tidal Volume

Pre-set Minute Ventilation

Variable Peak Inspiratory Pressures

Time Cycle

Constant Flow

I:E Ratio Controlled

Pressure Control (PCV)

Pre-set Peak Pressure

Variable Inspiratory Tidal Volume

Time Cycle

Decelerating Flow

I:E Ratio Controlled

Continuous Distending Pressure

Page 4: Target Volume Precise Volume Delivery Periop Advanced ...aacpma.com/Equipment/Draeger/Apollo/pdf's/Apollo Vol AF Mode... · 1 | 4 Apollo Volume AF | 07/2010 Volume AF Mode Presentation:

Apollo Volume AF | 07/20104 | 4

Apollo: Volume AFGraphical Curves

Volume Control Ventilation

• Constant Inspiratory Flow

• Variable Peak Inspiratory Pressure

Pressure Control Ventilation

• Decelerating Inspiratory Flow

• Variable Tidal Volume

Page 5: Target Volume Precise Volume Delivery Periop Advanced ...aacpma.com/Equipment/Draeger/Apollo/pdf's/Apollo Vol AF Mode... · 1 | 4 Apollo Volume AF | 07/2010 Volume AF Mode Presentation:

Apollo Volume AF | 07/20105 | 4

Apollo: Volume AFDisadvantages of VCV and PCV

VCV

Peak Pressures affected byPulmonary C and R

Potential Lung Overdistension- High Pressure Limit

Barotrauma

Volutrauma

PCV

Tidal Volume is not guaranteed

Potential Lung Overdistension- Transition post Laparoscopy

Volutrauma

Low exhaled Tidal Volume

Page 6: Target Volume Precise Volume Delivery Periop Advanced ...aacpma.com/Equipment/Draeger/Apollo/pdf's/Apollo Vol AF Mode... · 1 | 4 Apollo Volume AF | 07/2010 Volume AF Mode Presentation:

Apollo Volume AF | 07/20106 | 4

Apollo: Volume AFMechanical Ventilation Challenges in Operating Room

Laparoscopy Prone

Robot

Page 7: Target Volume Precise Volume Delivery Periop Advanced ...aacpma.com/Equipment/Draeger/Apollo/pdf's/Apollo Vol AF Mode... · 1 | 4 Apollo Volume AF | 07/2010 Volume AF Mode Presentation:

Apollo Volume AF | 07/20107 | 4

Apollo: Volume AFAdvanced Ventilation Mode

Dual Control Mode

Volume Control

+

Pressure Control = Vol AF

Page 8: Target Volume Precise Volume Delivery Periop Advanced ...aacpma.com/Equipment/Draeger/Apollo/pdf's/Apollo Vol AF Mode... · 1 | 4 Apollo Volume AF | 07/2010 Volume AF Mode Presentation:

Apollo Volume AF | 07/20108 | 4

Apollo: Volume AFAdvanced Ventilation Mode

Volume Autoflow

Vol AF

Targets the set Tidal Volume

Pressure Control Strategy

Using the Lowest Working Pressure

Minimal Peak Pressure Changes

Automatic Changes in Peak Pressure

+/- 3 cmH2O maximum PIP change

Illustration:

Transition from VCV to Vol. AF

Page 9: Target Volume Precise Volume Delivery Periop Advanced ...aacpma.com/Equipment/Draeger/Apollo/pdf's/Apollo Vol AF Mode... · 1 | 4 Apollo Volume AF | 07/2010 Volume AF Mode Presentation:

Apollo Volume AF | 07/20109 | 4

Apollo: Volume AFAdvanced Ventilation Mode

Vt

Peak Pressure changes

&

Page 10: Target Volume Precise Volume Delivery Periop Advanced ...aacpma.com/Equipment/Draeger/Apollo/pdf's/Apollo Vol AF Mode... · 1 | 4 Apollo Volume AF | 07/2010 Volume AF Mode Presentation:

Apollo Volume AF | 07/201010 | 4

Apollo: Volume AFAdvanced Ventilation Mode

Begin by setting Tidal Volume

Adjust frequency to achieve MV

Determine appropriate Pmax

Set desired PEEP

Observe Peak Pressure

Auto Set Limits (alarms)

Page 11: Target Volume Precise Volume Delivery Periop Advanced ...aacpma.com/Equipment/Draeger/Apollo/pdf's/Apollo Vol AF Mode... · 1 | 4 Apollo Volume AF | 07/2010 Volume AF Mode Presentation:

Apollo Volume AF | 07/201011 | 4

Apollo: Volume AFVol AF Sync PS

Vol AF with Sync PS

Pps

Trigger

Slope

I:E Ratio

Page 12: Target Volume Precise Volume Delivery Periop Advanced ...aacpma.com/Equipment/Draeger/Apollo/pdf's/Apollo Vol AF Mode... · 1 | 4 Apollo Volume AF | 07/2010 Volume AF Mode Presentation:

Apollo Volume AF | 07/201012 | 4

Apollo: Volume AFExtra Settings

Extra Settings

Age years

Weight

Trigger

Tslope

Page 13: Target Volume Precise Volume Delivery Periop Advanced ...aacpma.com/Equipment/Draeger/Apollo/pdf's/Apollo Vol AF Mode... · 1 | 4 Apollo Volume AF | 07/2010 Volume AF Mode Presentation:

Apollo Volume AF | 07/201013 | 4

Apollo: Volume AFCompare Vol AF to Vol AF Sync PS

Vol AF Sync PSVol AF

Page 14: Target Volume Precise Volume Delivery Periop Advanced ...aacpma.com/Equipment/Draeger/Apollo/pdf's/Apollo Vol AF Mode... · 1 | 4 Apollo Volume AF | 07/2010 Volume AF Mode Presentation:

Apollo Volume AF | 07/201014 | 4

Apollo: Volume AFVideo