ICU clinical simulator
Mechanical Ventilation Simulator
Watch pressure, flow and volume waveforms on a ventilator-style screen. Read the pressure, flow and volume waveforms, name the diagnosis, and get an explanation of why you were right or wrong. Then explore eight lung conditions in the free lab. Every key equation is worked out live.
- Diagnosis challenge
- Free lab with 8 conditions
- Live equations
- Works in your web browser
Simulator
Read the graphs and name the diagnosis
Diagnosis challenge
Guided cases with tasks
Free lab
Ppeak
0
cmH2O
Pplat
0
cmH2O
PEEP
0
cmH2O
Vt
0
mL
RR
0
breaths/min
Cstat
0
mL/cmH2O
Heart rate
0
BP (MAP)
0
SpO2
0
Last hold
None
What to look for
Blood gas
pH
–PaCO2 (kPa)
–PaO2 (kPa)
–HCO3 (mmol/L)
–Shown for the settings when you pressed the button.
Lung-protective checks
Live equations
Patient and oxygenation
Pressure rise: which is it?
| Ppeak | Pplat | Think |
|---|---|---|
| High | Normal | Resistance: bronchospasm, secretions, kinked or bitten tube |
| High | High | Compliance: pneumothorax, right main bronchus tube, oedema, ARDS, tense abdomen, obesity |
| Low | Low | Leak or disconnection (not simulated here) |
Sudden alarm: think DOPE. Displaced tube, Obstruction, Pneumothorax, Equipment.
Questions
Frequently asked questions
Why is Ppeak different from Pplat?
Ppeak is the highest pressure in the breath and includes the pressure needed to push gas through the airways. Pplat is measured when flow stops at the end-inspiratory pause, so it reflects only the stretch of the lung and chest wall. A wide gap points to high airway resistance. A high Pplat with a narrow gap points to low compliance.
What is the difference between volume control and pressure control?
In volume control you set the tidal volume and the flow, and the pressure is the result. If the compliance falls, the pressure rises. In pressure control you set the pressure and the volume is the result. If the compliance falls, the tidal volume falls. Try both modes on the ARDS case and compare.
Why is the asthma expiratory flow slow?
Narrow airways slow the gas leaving the lung. The time constant is the resistance multiplied by the compliance, so a high resistance gives a long time constant. If the next breath starts before expiration is finished, gas is trapped and auto-PEEP builds up.
How do I reduce air trapping?
Lengthen the expiratory time: lower the respiratory rate, shorten the inspiratory time, or reduce the tidal volume. Treat the cause too, for example the bronchospasm. Watch the auto-PEEP and the expiratory flow trace.
Why is the driving pressure important?
The driving pressure is the tidal volume divided by the compliance. It shows how much stretch each breath puts on the lung. In ARDS, a lower driving pressure has been linked to better survival, and a value above 15 cmH2O is usually seen as a warning.
How do I measure auto-PEEP?
Press the expiratory hold. The ventilator closes its valves at the end of expiration, and the pressure in the circuit rises to the total PEEP. Auto-PEEP is the total PEEP minus the set PEEP. If the patient is hypotensive and the chest is full of trapped gas, disconnect from the ventilator and let the chest empty.
How do I choose a new respiratory rate from a blood gas?
Use desired RR = (current RR × current PaCO2) ÷ desired PaCO2. It assumes the tidal volume, dead space and CO2 production stay the same. In metabolic acidosis the patient was breathing fast to lower the PaCO2, so the ventilator must give a similar minute ventilation.
What is the RSBI?
The rapid shallow breathing index is the respiratory rate divided by the tidal volume in litres, measured during a spontaneous breathing trial. A value under 105 breaths per minute per litre favours a successful extubation. It is one piece of information, not a rule.
Is this a real ventilator or for patient care?
No. It is a simplified teaching model with fixed example values, styled like a ventilator screen. It is for education only, not for clinical decision making, and it is not affiliated with any ventilator manufacturer. Always follow your local protocols.
