1
00:00:00,00 --> 00:00:26,500
Patient intubated due to status asthmaticus

2
00:00:26,600 --> 00:00:50,500
SIMV mode, 70kg, Vt 620 ml,IT 1.7sec, RR 
18, Fio2 40%

3
00:00:50,600 --> 00:00:55,400
O2 Sat 98%, pH 7.4, pCO2 30

4
00:01:00,400 --> 00:01:25,000
Expiratory flow is limited with decrease 
peak expiratory flow

5
00:01:25,100 --> 00:01:29,900
flow does not return to baseline (0)

6
00:01:30,000 --> 00:01:51,400
next BREATH starts before emptying the lung 
COMPLETELY =     AIR TRAPPING

7
00:01:51,500 --> 00:02:20,100
allow more time of expiration

8
00:02:35,500 --> 00:02:59,000
1.Vt was decreased to 7 ml/kg = 480ml previously 
its 620ml (pCO2 = 30).

9
00:02:59,100 --> 00:03:17,900
See that dynamic hyperinflation has improve 
lightly

10
00:03:18,000 --> 00:03:29,900
2.RR is slightly elevated, decrease RR to 
14 from 18. observe the I:E ratio.

11
00:03:30,000 --> 00:03:34,800
Gaining more time in expiration..DH is improving.

12
00:03:52,900 --> 00:04:20,900
3.Decreasing ITime of 1.7 can help...in which 
Plateau is eliminated with more prolonged 
ETime.

13
00:04:21,000 --> 00:04:25,800
expiratory flow is improved,

14
00:04:25,900 --> 00:04:52,200
4.to prolong more expiratory time, increase 
the flow to 60.

15
00:04:52,300 --> 00:06:34,600
Increasing flow to 60 will deliver the tidal 
volume more faster, PIP increases but not 
the plateau pressure.Notice that the AUTO 
PEEP HAVE BEEN ELIMATED.