Automatic Tube Compensation

This tutorial is about Automatic Tube Compensation (ATC).
ATC is a setting that has been included in most modern ventilators. Its aim is to reduce the work of breathing associated with the drop in pressure across the endotracheal tube. The ventilator senses pressure, flow and resistance and changes the pressure during the breath to ensure that the patient has the sensation that they are breathing through their own airway.
There are two configurations of ATC - one is as an alternative to pressure support in patients who are essentially weaned from mechanical ventilation: essentially a spontaneous breathing trial. The second configuration is as an accessory to all pressure limited modes - such that the pressure waveform is crafted in inspiration and expiration to reduce the workload of breathing during both phases of respiration.
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Contents
00:06 Introduction
01:00 Clinical Scenario
01:40 A Quick Review of Inspiration & Expiration
02:22 Work of Breathing
02:56 Work of Breathing Diseased Lungs, Endotracheal Tube
04:15 Pressure Loss Along the Airway
04:50 Increasing Gas Flow Increases Resistance
05:30 Airway Resistance – Normal Airways vs Different Endotracheal Tube Sizes
06:45 Equation of Motion
07:45 Spontaneous Breathing Through Endotracheal Tube
08:30 Pressure Support and the Work of Breathing
09:30 How Do You Know If Pressure Support is Too Much OR Too Little
10:00 Pressure Support and Alveolar Pressure
10:40 Pressure Support and Tracheal Pressure
11:30 The Major Flaw with Pressure Support
12:00 Automatic Tube Compensation (ATC)– what it is
13:00 ATC Puritan Bennett Ventilator
14:15 ATC and Tracheal Pressure
15:30 Setting Up ATC (PB Ventilator)
16:56 ATC – Ventilator Waveforms
18:20 ATC as an Alternative to PSV
19:20 ATC on Drager and Hamilton Ventilators
20:00 ATC and Expiratory Support
21:45 ATC In Addition to Pressure Limited Modes
23:20 ATC on Drager Vent Screen
25:00 Clinical Scenario Resolution
25:25 Review of Tutorial