Inhaled/Expiratory Tidal Volumes not matching on the PB 840

July 12, 2004, 02:55 AM

<ROMADRRT>

I am an RRT in the NICU and we use the PB 840 to venntilate the babies. While working tonight I had the Neonatologist ask me why the Exhaled Tidal Volume did not match with the Inhaled Tidal Volumes. Inhaled=43/Exhaled=20. Now I am not too stupid to know that that is an indication of a leak somewhere, but on the 4 PB 840 vents we have running, nothing put in equaled what was coming out. Not even close. I understand that since the tubes are cuffless, there will be leaks. But I repositioned the tube, tried repositioning the head; even applied Cricoid pressure and this is what happened. In increase in Inhaled and Exhaled volumes. But no match. Why?? Does it have to do with the tubing compliance? I changed the expitaratory filter thinking that might be it, still nothing. I looked at the 840's Operator Manual, useless!! I know it is a leak, it has to be. But why can't it be fixed. Please help my madness!! It is driving me crazy that I can't solve this. Thanks.

August 06, 2004, 10:21 AM

<Bignow>

No proximal monitoring so the 840 has to read volumes delivered and returned inside the vent. Could be a leak, could be compliance changes in the circuit after an EST has been run (EST on cold circuit then adding humidity= Changed compliance). Just some thoughts.

August 06, 2004, 10:58 AM

<ahensley>

quote:
Originally posted by ROMADRRT:
I am an RRT in the NICU and we use the PB 840 to venntilate the babies. While working tonight I had the Neonatologist ask me why the Exhaled Tidal Volume did not match with the Inhaled Tidal Volumes. Inhaled=43/Exhaled=20. Now I am not too stupid to know that that is an indication of a leak somewhere, but on the 4 PB 840 vents we have running, nothing put in equaled what was coming out. Not even close. I understand that since the tubes are cuffless, there will be leaks. But I repositioned the tube, tried repositioning the head; even applied Cricoid pressure and this is what happened. In increase in Inhaled and Exhaled volumes. But no match. Why?? Does it have to do with the tubing compliance? I changed the expitaratory filter thinking that might be it, still nothing. I looked at the 840's Operator Manual, useless!! I know it is a leak, it has to be. But why can't it be fixed. Please help my madness!! It is driving me crazy that I can't solve this. Thanks.

September 26, 2004, 10:35 AM

<Cpap>

quote:
Originally posted by ROMADRRT:
I am an RRT in the NICU and we use the PB 840 to venntilate the babies. While working tonight I had the Neonatologist ask me why the Exhaled Tidal Volume did not match with the Inhaled Tidal Volumes. Inhaled=43/Exhaled=20. Now I am not too stupid to know that that is an indication of a leak somewhere, but on the 4 PB 840 vents we have running, nothing put in equaled what was coming out. Not even close. I understand that since the tubes are cuffless, there will be leaks. But I repositioned the tube, tried repositioning the head; even applied Cricoid pressure and this is what happened. In increase in Inhaled and Exhaled volumes. But no match. Why?? Does it have to do with the tubing compliance? I changed the expitaratory filter thinking that might be it, still nothing. I looked at the 840's Operator Manual, useless!! I know it is a leak, it has to be. But why can't it be fixed. Please help my madness!! It is driving me crazy that I can't solve this. Thanks.