Pressure Support 4 – Expiratory Cycling

This is likely the most important of the four tutorials on Pressure Support Ventilation. As you may recall, PS is an unusual mode of ventilation because it is flow cycled – that is – the ventilator cycles to expiration as specific, user set, percentage of peak flow. The default expiratory sensitivity is usually around 25%. Expiratory dys-synchrony is frequently missed by bedside clinicians who have not been schooled in waveform analysis. This tutorial covers everything you need to know. @ccmtutorials

Next time I am going to commence a series of tutorials on hypoxia-hypoxemia. This will start with a discussion about how we measure hypoxemia – in particular oxyhemoglobin saturation (Tutorial 12). I will then go on to discuss atelectasis, shunt, ventilation-perfusion mismatch and introduce oxygen therapy (Tutorial 13).

Tutorial 4 – Cycling The Mechanical Ventilator – Available Now

This is the last tutorial in the introductory module – “setting up a mechanical ventilator.” In this tutorial I will discuss how the ventilator cycles from inspiration to expiration. In controlled modes this is usually time cycling. However, traditionally volume cycling of volume control was used. On occasion the ventilator pressure cycles – and you must be aware of this as it may cause problems. Finally I will introduce the concept of flow cycling: it is imperative that you understand this process if you use pressure support ventilation. I guarantee you will learn something in this tutorial.

Next week we will be moving on to Volume Controlled Ventilation – specifically Volume Assist Control.

Plan For Upcoming Tutorials (Available Wednesdays – 09.00 GMT)

[These Dates are Subject to Change as the Course Progresses – I will try to keep this list updated].

March 1st 2023
Tutorial 5: Volume Assist Control Ventilation

March 8th 2023
Tutorial 6: Synchronized Intermittent Mandatory Ventilation

March 15th 2023
Tutorial 7: Understanding Ventilation & CO2 Clearance

March 22nd 2023
End Tidal CO2 – Everything You Need to Know

March 29th 2023
Tutorial 8: Pressure Support Part 1 – Triggering the Breath

April 5th 2023
Tutorial 9: Pressure Support Part 2: Controlling the Initial Flow (the rise time)

April 12th 2023
Tutorial 10: Pressure Support Part 3: Setting the Pressure Support Level

April 19th 2023
Tutorial 11: Pressure Support Part 4: Controlling Exhalation (the EXPsens)

April 26th 2023
Tutorial 12: Identifying and Quantifying Hypoxemia

May 3rd 2023
Tutorial 13: Mechanisms of Hypoxemia Part 1

May 10th 2023
Tutorial 14: Mechanisms of Hypoxemia Part 2, Introduction the Oxygen Therapy & Hyperoxia

May 17th 2023
Tutorial 15: Oxygen Therapy

May 24th 2023
Tutorial 16: Why Low Lung Volumes are Bad

May 31st 2023
Tutorial 17: CPAP and PEEP

June 7th 2023
Tutorial 18: Non Invasive Ventilation

June 14th 2023
Tutorial 19: Pressure Controlled Ventilation – Part 1 Assist Control

June 21st 2023
Tutorial 20: Pressure Controlled Ventilation – Part 2 Volume Guaranteed Pressure Control

June 28th 2023
Tutorial 21: Pressure Controlled Ventilation – Part 3 BiLevel Pressure Control and APRV

July 5th 2023
Tutorial 22: How To Read A Blood Gas – Part 1 – Carbon Dioxide

July 12th 2023
Tutorial 23: How To Read A Blood Gas – Part 2 – Metabolic Disorders

July 19th 2023
Tutorial 24: The Patient with High Airway Pressures – Part 1 – Airway Pressure Monitoring and Flow Volume Loops

July 26th 2023
Tutorial 25: The Patient with High Airway Pressures – Part 2 – Treating the Problem

August 2nd 2023
Tutorial 23: The Patient is Fighting the Ventilator – Part 1

August 9th 2023
Tutorial 24: The Patient is Fighting the Ventilator – Part 2

August 16th 2023
Tutorial 25: ARDS – Part 1 – Understanding the Disease

August 23rd 2023
Tutorial 26: ARDS – Part 2 – Treating the Patient with ARDS

August 30th 2023
Tutorial 27: Pulmonary Edema

September 6th 2023
Tutorial 28: Pulmonary Embolism

September 13th 2023
Tutorial 29: Ventilator Weaning and Liberation

September 20th 2023
Tutorial 30: Tracheostomy