Lompat ke: ⚡ DOPE 🎯 Target Parameter ⚠️ Komplikasi 📈 Waveform
Troubleshooting Cepat — DOPE Mnemonic
D — Displacement
O — Obstruction
P — Pneumothorax
E — Equipment
Target Parameter Dewasa per Kondisi
KondisipHPaO₂ (mmHg)PaCO₂ (mmHg)SpO₂Pplat
Normal / Post-op7.35–7.4580–10035–4594–98%<25
ARDS Mild7.30–7.4555–8035–50 perm88–95%<30
ARDS Moderate-Severe>7.2055–8045–65 perm88–95%≤28
PPOK Eksaserbasi7.25–7.4055–70Baseline ↑ perm88–92%<30
Asma Berat>7.2060–9045–70 perm94–98%<30
Sepsis/Pneumonia7.30–7.4560–10035–5092–96%<30
GBS/MG7.35–7.4580–10035–45≥95%<28
Edema Paru Kardiogenik7.35–7.4570–10035–4592–96%<25
Komplikasi Ventilasi Mekanik
VILI (Ventilator Induced Lung Injury)

Mekanisme: Volutrauma, barotrauma, atelectrauma, biotrauma

Pencegahan: VT 6 mL/kg IBW, Pplat ≤30, driving pressure ≤15, PEEP titrasi optimal

VAP (Ventilator-Associated Pneumonia)

Definisi: Pneumonia >48 jam setelah intubasi

Pencegahan: Bundle VAP (HOB 30°, oral hygiene CHX, SAT/SBT daily, cuff pressure 20–30)

VIDD (Diaphragm Dysfunction)

Mekanisme: Controlled ventilation → disuse atrophy diafragma dalam 18–69 jam

Pencegahan: Preserve spontaneous breathing effort; hindari deep sedation lama; gunakan PSV mode

Monitoring Waveform & Loop

Deteksi Auto-PEEP

  • Flow-time grafik: garis flow tidak kembali ke nol sebelum napas berikutnya
  • Ekspiratory hold (0.5–1 detik): baca auto-PEEP dari display
  • Klinis: PIP ↑, TD drop, sinkronisasi buruk
  • Aksi: ↓ RR, ↓ I:E (perpanjang ekspirasi), ↑ flow rate, bronkodilator

P-V Loop Abnormal

  • Upper inflection point: Overdistensi → turunkan VT/Pplat
  • Lower inflection point: Atelektasis → naikkan PEEP di atas LIP
  • Penduluft: Alveoli terbuka-tutup siklik → ubah PEEP
  • Beaked loop: Air trapping/auto-PEEP pada asma/PPOK
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