![]() ![]() For all infants receiving assisted ventilation, clinicians require accurate technologies to continuously measure V t until respiratory stability is reached to minimize the risk of VILI. Ideal techniques to measure continuous, bi-directional airflow proximal to the endotracheal tube require accuracy over a range of airflow, negligible contribution to dead space and resistive load, reliability, minimal need for operator intervention or calibration, adaptability to a warmed and humidified environment, and validated performance for long-term use. Currently, pneumotachography is the most commonly utilized bedside technology. Tidal volumes (V t) can be measured continuously by monitoring airflow signals of assisted ventilation. Extra volume that can be inspired above tidal volume, from normal quiet inspiration to maximum inspiration: 2.5L: Relies on muscle strength, lung compliance (elastic recoil) and a normal starting point (end of tidal volume) Expiratory reserve volume: Extra volume that can be expired below tidal volume, from normal quiet expiration to maximum. Understanding of physiologic determinants of tidal volume allow for optimal tidal volume delivery by using minimal pressures to achieve desired carbon dioxide exchange without air-trapping. ![]() Dangerously high tidal volumes are often estimated for patients who are obese or shorter than average. This isn't quite as easy as it sounds, because ideal body weight is based on gender and height (not actual weight). This biotrauma triggers a cascade of proinflammatory responses associated with an increased occurrence of bronchopulmonary dysplasia (BPD). The crux of this is setting tidal volume at 6-8 cc/kg ideal body weight. In uniquely vulnerable preterm infants, excessive tidal volume, volutrauma, is a significant contributor to ventilator-induced lung injury (VILI). Expiratory reserve volume which is the volume of air that can be extracted forcefully during exhalation, after the expiration of the normal volume. Some ventilation modes target tidal volume without taking into. ![]()
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