Chapter 7

Operating Theory

Patient Leak Display

Estimated patient leak (Pt Leak) is displayed in LPM and updated at each breath. Pt Leak is the average leak rate during a breath (delivered volume minus exhaled volume divided by the breath time).

Pt Leak is estimated breath by breath. If the physical characteristics of the leak change, there will be a corresponding change in the actual leak flow, which will be detected and leak estimation will be updated in subsequent breaths. Physical characteristics of leaks are determined by a number of factors, for example, the size and shape of the leak (such as a gap in the seal between the mask and face). Leaks that may occur during invasive ventilation are usually undesirable and are not compensated to allow easier leak detection.

Ventilation Modes Common to NPPV

Non-Invasive Positive Pressure Ventilation (NPPV)

In Non-Invasive Ventilation, gas is delivered to the patient via a nasal mask, full face mask, nasal pillows, or mouthpiece with a lip seal. The operator determines whether the mode is totally spontaneous (Spont Ventilation Mode) or spontaneous with a backup rate (Spont/T Ventilation Mode).

Spontaneous Ventilation Mode (Spont)

In Spontaneous Ventilation Mode, the operator sets the pressure during exhalation (EPAP) and the target pressure during inspiration (IPAP). The patient triggers the breath based on the Flow Trigger setting. Exhalation is determined by the setting E-Trigger, which is a percentage of peak flow during the breath. Refer to Figure 7-7.

Spontaneous/Timed Ventilation Mode (Spont/T)

In the Spontaneous/Timed Ventilation Mode, the patient can breathe spontaneously, or receive machined controlled breaths. The machine controlled breaths are delivered for a set inspiratory time at a set breath rate. In Spont/T mode, every patient initiated breath is spontaneous and restarts the breath period timer. If the patient triggers a breath before the breath period elapses, the ventilator delivers a spontaneous supported breath (based upon the settings). If the breath period elapses without a patient trigger, the ventilator delivers a ventilator initiated mandatory breath at the set IPAP level. Patient initiated, time cycled breaths are not delivered in Spont/T mode. Refer to Figure 7-7.

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Respironics V200 Ventilator Operator’s Manual

REF 1057983 A

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Philips V200 manual Ventilation Modes Common to Nppv, Patient Leak Display, Non-Invasive Positive Pressure Ventilation Nppv
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