optimal peep selection in mechanical ventilation using eit
play

Optimal PEEP selection in Mechanical Ventilation using EIT Ravi B. - PowerPoint PPT Presentation

Feb 29, 2024 •150 likes •768 views

Optimal PEEP selection in Mechanical Ventilation using EIT Ravi B. Bhanabhai Carleton University - 2009/11 M.A.Sc January 20, 2012 Ravi B. Bhanabhai (Carleton U) Safe Keeping Ventilation Patients 01/20/2012 1 / 28 Outline Introduction 1

  1. Optimal PEEP selection in Mechanical Ventilation using EIT Ravi B. Bhanabhai Carleton University - 2009/11 M.A.Sc January 20, 2012 Ravi B. Bhanabhai (Carleton U) Safe Keeping Ventilation Patients 01/20/2012 1 / 28

  2. Outline Introduction 1 The Problem How to solve the problem? Contributions 2 IP Calculation Fuzzy Logic System Results 3 Sigmoid vs. Linear Linear vs. Visual Optimal PEEP References 4 Ravi B. Bhanabhai (Carleton U) Safe Keeping Ventilation Patients 01/20/2012 2 / 28

  3. Introduction Introduction This is a presentation outlining the work done within Ravi Bhanabhai M.A.Sc thesis. Purpose: Investigate the use of Electrical Impedance Tomography (EIT) within mechanical ventilation. Ravi B. Bhanabhai (Carleton U) Safe Keeping Ventilation Patients 01/20/2012 3 / 28

  4. Introduction Introduction This is a presentation outlining the work done within Ravi Bhanabhai M.A.Sc thesis. Purpose: Investigate the use of Electrical Impedance Tomography (EIT) within mechanical ventilation. Mathematical Tools: Linear and Non-Linear curve fitting techniques 1 Fuzzy Logic. 2 Ravi B. Bhanabhai (Carleton U) Safe Keeping Ventilation Patients 01/20/2012 3 / 28

  5. Introduction Introduction This is a presentation outlining the work done within Ravi Bhanabhai M.A.Sc thesis. Purpose: Investigate the use of Electrical Impedance Tomography (EIT) within mechanical ventilation. Mathematical Tools: Linear and Non-Linear curve fitting techniques 1 Fuzzy Logic. 2 Contribtions: Summarize scholarly papers on ALI. 1 Inflection Point (IP) location on EIT and pressure data. 2 Creation of Fuzzy Logic System using IP. 3 Ravi B. Bhanabhai (Carleton U) Safe Keeping Ventilation Patients 01/20/2012 3 / 28

  6. Introduction Introduction This is a presentation outlining the work done within Ravi Bhanabhai M.A.Sc thesis. Purpose: Investigate the use of Electrical Impedance Tomography (EIT) within mechanical ventilation. Mathematical Tools: Linear and Non-Linear curve fitting techniques 1 Fuzzy Logic. 2 Contribtions: Summarize scholarly papers on ALI. 1 Inflection Point (IP) location on EIT and pressure data. 2 Creation of Fuzzy Logic System using IP. 3 Novel Aspects: Use of short recruitment maneuever ( ≤ 2min) 1 Regional Inflection Points used 2 Use of Inflection Points within an automated classification system 3 Ravi B. Bhanabhai (Carleton U) Safe Keeping Ventilation Patients 01/20/2012 3 / 28

  7. Introduction The Problem ALI & VILI Respiratory Failure Oxygenation Ventilatory Failure Failure (hypercapnia) (hypoxemia) + more oxygen related conditions Acute Lung Injury Ventilator Induce Lung Injury (ALI) (VILI) * Cyclic opening and closing PEEP * overdistension Ravi B. Bhanabhai (Carleton U) Safe Keeping Ventilation Patients 01/20/2012 4 / 28

  8. Introduction How to solve the problem? Respiratory Function Models P ao = V C + ˙ V R + ¨ V I − P mus (1) Ravi B. Bhanabhai (Carleton U) Safe Keeping Ventilation Patients 01/20/2012 5 / 28

  9. Introduction How to solve the problem? Respiratory Function Models P ao = V C + ˙ V R + ¨ V I − P mus (1) Interested in V C only. Ravi B. Bhanabhai (Carleton U) Safe Keeping Ventilation Patients 01/20/2012 5 / 28

  10. Introduction How to solve the problem? Respiratory Function Models P ao = V C + ˙ V R + ¨ V I − P mus (1) Interested in V C only. To remove other components this thesis data did two things: Slow Constant Flow 1 Antheysia 2 Ravi B. Bhanabhai (Carleton U) Safe Keeping Ventilation Patients 01/20/2012 5 / 28

  11. Linear Fit − Inflation Linear Fit − Deflation 6 6 Original Original EIT Conductivity EIT Conductivity 4 4 Sigmoid Fitted Sigmoid Fitted Inflection Points Inflection Points 2 2 0 0 −2 −2 0 5 10 15 20 25 30 35 0 5 10 15 20 25 30 35 Pressure (mbar) Pressure (mbar) Introduction How to solve the problem? Pressure-Volume Curves Used to help guide ventilation strategies by locating points of compliance change. Ravi B. Bhanabhai (Carleton U) Safe Keeping Ventilation Patients 01/20/2012 6 / 28

  12. Linear Fit − Inflation Linear Fit − Deflation 6 6 Original Original EIT Conductivity EIT Conductivity 4 4 Sigmoid Fitted Sigmoid Fitted Inflection Points Inflection Points 2 2 0 0 −2 −2 0 5 10 15 20 25 30 35 0 5 10 15 20 25 30 35 Pressure (mbar) Pressure (mbar) Introduction How to solve the problem? Pressure-Volume Curves Used to help guide ventilation strategies by locating points of compliance change. Points are Lower Inflection Point (LIP) and Upper Inflection Point (UIP) Ravi B. Bhanabhai (Carleton U) Safe Keeping Ventilation Patients 01/20/2012 6 / 28

  13. Introduction How to solve the problem? Pressure-Volume Curves Used to help guide ventilation strategies by locating points of compliance change. Points are Lower Inflection Point (LIP) and Upper Inflection Point (UIP) Linear Fit − Inflation Linear Fit − Deflation 6 6 Original Original EIT Conductivity EIT Conductivity 4 4 Sigmoid Fitted Sigmoid Fitted Inflection Points Inflection Points 2 2 0 0 −2 −2 0 5 10 15 20 25 30 35 0 5 10 15 20 25 30 35 Pressure (mbar) Pressure (mbar) (e) Linear Fit of PI data Time Alignment 1 global EIT Pressure 0.8 0.6 0.4 0.2 Ravi B. Bhanabhai (Carleton U) Safe Keeping Ventilation Patients 01/20/2012 6 / 28 0 −20 −10 0 10 20 30

  14. Introduction How to solve the problem? Data used Data used: 26 patients low constant flow maneuver (4 L/min) start 0 mbar → 35 mbar / 2L Pressure Maneuver 20 Pressure [mbar] 15 10 5 0 20 40 60 80 100 120 140 160 180 200 Volume Maneuver 1500 Volume [ml] 1000 500 0 20 40 60 80 100 120 140 160 180 200 Flow Maneuver 40 Flow [L/min] 20 0 −20 20 40 60 80 100 120 140 160 180 200 Time [sec] Ravi B. Bhanabhai (Carleton U) Safe Keeping Ventilation Patients 01/20/2012 7 / 28

  15. Introduction How to solve the problem? Electrical Impedance Tomography (EIT) EIT is real-time impedance tomography, it can be used to accuratly measure air distrubtion within the thorax. Ravi B. Bhanabhai (Carleton U) Safe Keeping Ventilation Patients 01/20/2012 8 / 28

  16. Introduction How to solve the problem? Electrical Impedance Tomography (EIT) EIT is real-time impedance tomography, it can be used to accuratly measure air distrubtion within the thorax. (a) Start of Inflation (b) Max Pressure (c) End of Deflation Figure: Example reconstruction using the GREIT methods of a healthy lung patient (patient 7). Ravi B. Bhanabhai (Carleton U) Safe Keeping Ventilation Patients 01/20/2012 8 / 28

  17. Contributions Contributions Automated IP calculation Ravi B. Bhanabhai (Carleton U) Safe Keeping Ventilation Patients 01/20/2012 9 / 28

  18. Contributions Contributions Automated IP calculation Rule-base Fuzzy Logic Classifier Ravi B. Bhanabhai (Carleton U) Safe Keeping Ventilation Patients 01/20/2012 9 / 28

  19. Contributions IP Calculation IP Calculation Three Types of IP location methods were used: Ravi B. Bhanabhai (Carleton U) Safe Keeping Ventilation Patients 01/20/2012 10 / 28

  20. Contributions IP Calculation IP Calculation Three Types of IP location methods were used: 1 Sigmoid method Ravi B. Bhanabhai (Carleton U) Safe Keeping Ventilation Patients 01/20/2012 10 / 28

  21. Contributions IP Calculation IP Calculation Three Types of IP location methods were used: 1 Sigmoid method 2 Visual heuristics Ravi B. Bhanabhai (Carleton U) Safe Keeping Ventilation Patients 01/20/2012 10 / 28

  22. Contributions IP Calculation IP Calculation Three Types of IP location methods were used: 1 Sigmoid method 2 Visual heuristics 3 3-piece linear spline method Ravi B. Bhanabhai (Carleton U) Safe Keeping Ventilation Patients 01/20/2012 10 / 28

  23. Contributions IP Calculation IP Calculation Three Types of IP location methods were used: 1 Sigmoid method 2 Visual heuristics 3 3-piece linear spline method Multiple methods were implemented for comparison reasons. Ravi B. Bhanabhai (Carleton U) Safe Keeping Ventilation Patients 01/20/2012 10 / 28

  24. Contributions IP Calculation Sigmoid Method Sigmoid Method 1200 c= 17 cm H20 1000 800 volume − ml Plip =c - 2d 600 =11.1 b= 1173 ml Plip =c +2d =22.9 400 200 a= 12ml 0 0 5 10 15 20 25 30 35 pressure − mbar Ravi B. Bhanabhai (Carleton U) Safe Keeping Ventilation Patients 01/20/2012 11 / 28

  25. Contributions IP Calculation Visual Heuristics Clinicians used this method to locate Inflection Points from global PV curves. Multiple methods exist: Ravi B. Bhanabhai (Carleton U) Safe Keeping Ventilation Patients 01/20/2012 12 / 28

  26. Contributions IP Calculation Visual Heuristics Clinicians used this method to locate Inflection Points from global PV curves. Multiple methods exist: Find location where PV curve has linear compliance 1 Ravi B. Bhanabhai (Carleton U) Safe Keeping Ventilation Patients 01/20/2012 12 / 28

  27. Contributions IP Calculation Visual Heuristics Clinicians used this method to locate Inflection Points from global PV curves. Multiple methods exist: Find location where PV curve has linear compliance 1 Pressure where rapid increase in compliance occurs 2 Ravi B. Bhanabhai (Carleton U) Safe Keeping Ventilation Patients 01/20/2012 12 / 28

Recommend

Mechanical Ventilation Weaning of the Difficult to Wean Morbidly Obese Patients: A Weighty

Mechanical Ventilation Weaning of the Difficult to Wean Morbidly Obese Patients: A Weighty

Mechanical Ventilation Weaning of the Difficult to Wean Morbidly Obese Patients: A Weighty Problem! Skip Bangley, RRT BS Disclosure I have none to report. No financial or other support was given. The study referenced in this presentation was

487 views • 37 slides
To Tube or Not to Tube: Invasive vs Non-Invasive Mechanical Ventilation Presented by: Mark Rose,

To Tube or Not to Tube: Invasive vs Non-Invasive Mechanical Ventilation Presented by: Mark Rose,

To Tube or Not to Tube: Invasive vs Non-Invasive Mechanical Ventilation Presented by: Mark Rose, BS, RRT (THD Staff RT and Collin College Clinical Instructor) @ 7th Annual SCCM Texas Chapter Symposium Disclosure Statement I do not have an

447 views • 28 slides
State Variation in Mechanical Ventilation of Hospitalized Patients with Advanced Dementia Joan M

State Variation in Mechanical Ventilation of Hospitalized Patients with Advanced Dementia Joan M

State Variation in Mechanical Ventilation of Hospitalized Patients with Advanced Dementia Joan M Teno, M.D., M.S. Susan Mitchell, MD, MPH Pedro Gozalo, Ph.D. Susan Tolle, MD Christine Ritchie, MD, MSPH Jen Bunker, MPH Jessica Orgarek, MS

273 views • 11 slides
Optimal ventilation and filtering strategies Barcelona - May, 7 2015 for air quality in carriages

Optimal ventilation and filtering strategies Barcelona - May, 7 2015 for air quality in carriages

Optimal ventilation and filtering strategies Barcelona - May, 7 2015 for air quality in carriages P . Blondeau, M. O. Abadie University of La Rochelle, France Open Day on Air quality in rail subway systems, CSIC Expansion of the existing rail

186 views • 16 slides
Prolonged Mechanical Ventilation Shannon S. Carson, MD Associate Professor and Chief Pulmonary

Prolonged Mechanical Ventilation Shannon S. Carson, MD Associate Professor and Chief Pulmonary

Prolonged Mechanical Ventilation Shannon S. Carson, MD Associate Professor and Chief Pulmonary and Critical Care Medicine University of North Carolina AJRCCM 2010 Projected Growth of Prolonged Acute MV Zilberberg et al. Crit Care Med

932 views • 23 slides
1 Principle of IAQ Control Principle of IAQ Control Goal: Ventilation Ventilation Air

1 Principle of IAQ Control Principle of IAQ Control Goal: Ventilation Ventilation Air

Typical Indoor Air Contaminants Department of Mechanical, Aerospace, and Manufacturing Engineeri Department of Mechanical, Aerospace, and Manufacturing Engineering ng College of Engineering and Computer Science College of Engineering and

430 views • 8 slides
Selection Rules: Selection Rules Each of the spectroscopies have associated selection

Selection Rules: Selection Rules Each of the spectroscopies have associated selection

Selection Rules: Selection Rules Each of the spectroscopies have associated selection rules. Selection rules originate from the quantum mechanical description of electromagnetic radiation interaction with matter. Use time-dependent

424 views • 13 slides
MECH 8250 Ventilation Winter 2014 Lecture: February 2 nd 08/09/2014 1 Topics Covered by this

MECH 8250 Ventilation Winter 2014 Lecture: February 2 nd 08/09/2014 1 Topics Covered by this

2/3/2015 MECH 8250 Ventilation Winter 2014 Lecture: February 2 nd 08/09/2014 1 Topics Covered by this Course Building Ventilation Systems BCBC 2012 ASHRAE 62.1 03/02/2015 2 1 2/3/2015 Natural Ventilation 03/02/2015 3 Mechanical

678 views • 29 slides
Weighted Quasi-optimal and Recursive Quasi-optimal Satellite Selection Techniques for GNSS V.

Weighted Quasi-optimal and Recursive Quasi-optimal Satellite Selection Techniques for GNSS V.

Weighted Quasi-optimal and Recursive Quasi-optimal Satellite Selection Techniques for GNSS V. Satya Srinivas 1 , A.D. Sarma 2 and A. Supraja Reddy 2 1 Geethanj ali College of Engineering and Technology, Cheeryal (V), Telangana 501301 India 2

466 views • 35 slides
PEEP recruitment maneuver Step 1 (lung) PEEP Recruits (opens) collapsed alveoli FiO

PEEP recruitment maneuver Step 1 (lung) PEEP Recruits (opens) collapsed alveoli FiO

2/1/2013 Case 1: 40 yo Male restrained driver high speed MVA P 140, RR 40 labored, BP 100/70, O 2 sat 70 Chestwheeze, crackles Robert M. Rodriguez, MD FAAEM Tender sternum and ribs without crepitus Clinical Professor of Medicine

486 views • 6 slides
High-Flow Oxygen & Mechanical Ventilation Donna Lynch-Smith, DNP, ACNP-BC, APRN, NE-BC, CNL

High-Flow Oxygen & Mechanical Ventilation Donna Lynch-Smith, DNP, ACNP-BC, APRN, NE-BC, CNL

High-Flow Oxygen & Mechanical Ventilation Donna Lynch-Smith, DNP, ACNP-BC, APRN, NE-BC, CNL Associate Professor/AG-ACNP Concentration Coordinator UTHSC CON High-Flow Oxygen High-Flow Oxygen Nasal Cannula (HFNC) Oxygen Supply System

418 views • 20 slides
Excellence in ventilation Introduction Excellence in ventilation Volution Group plc is a leading

Excellence in ventilation Introduction Excellence in ventilation Volution Group plc is a leading

Volution Group plc Full year results to 31 July 2017 Excellence in ventilation Introduction Excellence in ventilation Volution Group plc is a leading supplier of ventilation products to the residential and commercial construction markets in

439 views • 25 slides
Excellence in ventilation Introduction Excellence in ventilation Volution Group plc is a leading

Excellence in ventilation Introduction Excellence in ventilation Volution Group plc is a leading

Volution Group plc Half year results to 31 January 2019 Excellence in ventilation Introduction Excellence in ventilation Volution Group plc is a leading supplier of ventilation products to the residential and commercial construction markets in

628 views • 26 slides
MECHANICAL VENTILATION MODULE III Jeffery C Rooks (Craig) MMHC, RRT Arna Banerjee MD, MMHC, FCCM

MECHANICAL VENTILATION MODULE III Jeffery C Rooks (Craig) MMHC, RRT Arna Banerjee MD, MMHC, FCCM

MECHANICAL VENTILATION MODULE III Jeffery C Rooks (Craig) MMHC, RRT Arna Banerjee MD, MMHC, FCCM Learning Objectives Select appropriate initial ventilator settings (ventilator prescription). Modify the ventilator prescription in

678 views • 38 slides
Panasonic Advanced Ventilation Fans Description Provide Effective and Quiet Ventilation without

Panasonic Advanced Ventilation Fans Description Provide Effective and Quiet Ventilation without

Panasonic Advanced Ventilation Fans Description Provide Effective and Quiet Ventilation without it looking like a Fan 8-1/4 12-3/4 Welcome to a new sales opportunity! WhisperRecessed is a single-speed, medium-profile ventilation fan with an

332 views • 9 slides
Ventilation of Confined Spaces Confined Space Ventilation Confined spaces are not normally

Ventilation of Confined Spaces Confined Space Ventilation Confined spaces are not normally

Ventilation of Confined Spaces Confined Space Ventilation Confined spaces are not normally designed for convenient ventilation Must take steps to: ensure air is breathable before entering confined space maintain acceptable air

567 views • 31 slides
Optimal Gateway Selection in Multi-domain Wireless Networks: A Potential Game Perspective Yang

Optimal Gateway Selection in Multi-domain Wireless Networks: A Potential Game Perspective Yang

1. Motivation 2. Gateway Selection Game 3. Equilibrium Selection Learning 4. Evaluation 5. Conclusions Optimal Gateway Selection in Multi-domain Wireless Networks: A Potential Game Perspective Yang Song, Starsky H.Y. Wong, and Kang-Won Lee

901 views • 51 slides
NASAL VENTILATION TYPE and TIMING of VENTILATION in the IN NEONATES FIRST POSTNATAL WEEK is

NASAL VENTILATION TYPE and TIMING of VENTILATION in the IN NEONATES FIRST POSTNATAL WEEK is

NASAL VENTILATION TYPE and TIMING of VENTILATION in the IN NEONATES FIRST POSTNATAL WEEK is ASSOCIATED with BRONCHOPULMONARY DYSPLASIA Vineet Bhandari, MD, DM (BPD)/DEATH Section of Neonatal Medicine, St. Christophers Hospital for

81 views • 6 slides
Metallurgy and Material Selection for Mechanical Engineers A Training Course Prepared and

Metallurgy and Material Selection for Mechanical Engineers A Training Course Prepared and

Metallurgy and Material Selection for Mechanical Engineers A Training Course Prepared and delivered by: Dr. A. K. Abdul Jawwad Chapter One Structure of Metals and Alloys Introduction Physical metallurgy is concerned with exploring

1.34k views • 96 slides
Optimal Inference After Model Selection Will Fithian Joint work with Dennis Sun & Jonathan

Optimal Inference After Model Selection Will Fithian Joint work with Dennis Sun & Jonathan

Optimal Inference After Model Selection Will Fithian Joint work with Dennis Sun & Jonathan Taylor December 11, 2015 Outline 1 Introduction 2 Inference After Selection 3 Linear Regression 4 Other Examples Two Stages Two stages of a

824 views • 69 slides
Pattern Selection for Optimal Classical Planning with Saturated Cost Partitioning Jendrik Seipp

Pattern Selection for Optimal Classical Planning with Saturated Cost Partitioning Jendrik Seipp

Pattern Selection for Optimal Classical Planning with Saturated Cost Partitioning Jendrik Seipp August 14, 2019 University of Basel, Switzerland Setting optimal classical planning pattern databases 1/14 A search + admissible

449 views • 24 slides
Optimal mass transport and density flows Tryphon Georgiou Mechanical & Aerospace Engineering

Optimal mass transport and density flows Tryphon Georgiou Mechanical & Aerospace Engineering

Optimal mass transport and density flows Tryphon Georgiou Mechanical & Aerospace Engineering University of California, Irvine Joint work with Yongxin Chen (MSKCC), M. Pavon (Padova) , A. Tannenbaum (Stony Brook), and Wilfrid Gangbo (UCLA)

965 views • 53 slides
Fewer Visible Vents #2 67% more vents per foot 9 out of 10 homeowners prefer the look of

Fewer Visible Vents #2 67% more vents per foot 9 out of 10 homeowners prefer the look of

We Believe Soffit should Do YOU meet #1 CODE ? Ventilation - 1202.2.1 Openings - 1202.2.2 The Net Free ventilation area Openings for ventilation shall not be less than 1/150 of having a least dimension of the area of the space not

409 views • 16 slides
Implementing ASHRAE 62.2 Ventilation Standards Wisconsins Experience WIs Experience w/

Implementing ASHRAE 62.2 Ventilation Standards Wisconsins Experience WIs Experience w/

Implementing ASHRAE 62.2 Ventilation Standards Wisconsins Experience WIs Experience w/ 62.2 WI moved to 62.2-December 2005 After 2004 Pilot of 62.2-2004 and 62.1(BTLa) ventilation requirements The link between ventilation

416 views • 37 slides

More recommend