The maximum pressure exerted against the patients airway during the breath
Peak inspiratory pressure refers to the maximum pressure reached during inspiration, while plateau pressure refers to the pressure measured when there is no airflow in the lungs at the end of an inspiratory pause. Plateau pressure is a better indicator of lung distensibility and risk of overinflation compared to peak inspiratory pressure.
Peak inspiratory pressure is important because it indicates the pressure required to deliver air into the lungs during mechanical ventilation. Monitoring peak inspiratory pressure helps in assessing the status of lung compliance and airway resistance, as well as in detecting potential complications such as barotrauma or lung overdistension. It also allows healthcare providers to adjust ventilator settings to optimize patient outcomes and prevent further lung injury.
The maximum pressure exerted against the patients airway during the breath.
If Peak Inspiratory Pressure or Peak Airway Pressure is reached too soon, this could be caused by airway obstruction, kinking of the ET tube, bronchospasm, low lung compliance or the pressure is set too low. ET tube cuff leak or ventilator circuit leak could be a cause if unable to reach PIP.
Inspiratory pressure refers to the amount of pressure generated during inhalation to expand the lungs and allow air to flow into the respiratory system. It is measured in centimeters of water pressure and is an important parameter to evaluate respiratory function, especially in conditions like asthma or COPD. Inspiratory pressure can be influenced by factors such as lung compliance and airway resistance.
More oxygen than carbon dioxide.
CPAP-Continuous Positive Airway Pressure, SiPAP-Synchronized inspiratory Positive Airway Pressure
30-40 bar peak pressure
The plateau pressure is the pressure applied (in positive pressure ventilation) to the small airways and alveoli. It is believed that control of the plateau pressure is important, as excessive stretch of alveoli has been implicated as the cause of ventilator induced lung injury. The peak pressure is the pressure measured by the ventilator in the major airways, and it strongly reflects airways resistance. For example, in acute severe asthma, there is a large gradient between the peak pressure (high) and the plateau pressure (normal). In pressure controlled ventilation, the pressure limit is (usually) the plateau pressure due to the dispersion of gas in inspiration. In volume control, the pressure measured (the PAW) by the ventilator is the peak airway pressure, which is really the pressure at the level of the major airways. To know the real airway pressure, the plateau pressure which is applied at alveolar level, the volume breath must be made to simulate a pressure breath. An inspiratory hold (0.5 to 1 second) is applied, and the airway pressure, from the initial peak, drops down to a plateau. The hold represents a position of no flow.
To perform a Negative Inspiratory Force (NIF) measurement, have the patient exhale fully, then place a handheld mouth pressure device or a manometer in their mouth, instruct them to breathe in as forcefully as possible, and record the highest inspiratory pressure generated. The NIF measurement helps assess respiratory muscle strength and can be useful in evaluating respiratory function in conditions like neuromuscular disorders or respiratory failure.
wheeze can be inspiratory or expiratory but stridor is mostly inspiratory
In manual ventilation you can increase the PaO2 by hyperventilating the patient, by increasing the respiratory rate and/or by increasing the volume of air that you deliver to the patient. If using a BVM for example, compressing the bag faster and/or harder will increase the arterial oxygen pressure, but there is a limit to what you can do with manual ventilation. Perfusion in the lungs has a major impact on PaO2. Also, the blood chenistry (anemia or CO2 poisoning) for example will dramatically decrease the PaO2. Sometimes no matter how much you hyperventilate the person, low PaO2 can't be corrected.