Ventilator. CONTENT… What is a ventilator? Types of ventilators Modes of ventilators Types of...

23
Ventilator

Transcript of Ventilator. CONTENT… What is a ventilator? Types of ventilators Modes of ventilators Types of...

Page 1: Ventilator. CONTENT… What is a ventilator? Types of ventilators Modes of ventilators Types of support Methods of ventilatory support Indications of ventilators.

Ventilator

Page 2: Ventilator. CONTENT… What is a ventilator? Types of ventilators Modes of ventilators Types of support Methods of ventilatory support Indications of ventilators.

CONTENT…

•What is a ventilator?•Types of ventilators•Modes of ventilators•Types of support•Methods of ventilatory support•Indications of ventilators

Page 3: Ventilator. CONTENT… What is a ventilator? Types of ventilators Modes of ventilators Types of support Methods of ventilatory support Indications of ventilators.

What is a ventilator???•A ventilator is a machine that supports

breathing •These machines mainly are used in hospitals •Ventilators▫Get oxygen into the lungs▫Remove carbon dioxide from the body ▫Help people breathe easier▫Breathe for people who have lost all ability to

breathe on their own

Page 4: Ventilator. CONTENT… What is a ventilator? Types of ventilators Modes of ventilators Types of support Methods of ventilatory support Indications of ventilators.
Page 5: Ventilator. CONTENT… What is a ventilator? Types of ventilators Modes of ventilators Types of support Methods of ventilatory support Indications of ventilators.

Types of ventilators…

•Negative pressure•Positive pressure

Page 6: Ventilator. CONTENT… What is a ventilator? Types of ventilators Modes of ventilators Types of support Methods of ventilatory support Indications of ventilators.

Negative Pressure Ventilators•Applies negative pressure around the chest wall.

This causes intra airway pressure to become negative. Thus drawing air into the lungs through the patients nose and mouth

•No artificial airway is necessary – patient must be able to control and protect own airway

• Indication▫Selected patient with neuromuscular problems▫Adjunct to weaning from PEEP(Positive end expiratory

pressure)•Negative pressure ventilators are simply to use and

do not require intubation of the airway

Page 7: Ventilator. CONTENT… What is a ventilator? Types of ventilators Modes of ventilators Types of support Methods of ventilatory support Indications of ventilators.

Positive Pressure Ventilators•Positive pressure ventilators inflate the lungs by

exerting positive pressure on the airway, forcing the alveoli to expand during inspiration

•Expiration occurs passively, endotracheal intubation or trachestomy is necessary in most cases

•These ventilators are widely used in the hospital setting

•There are Three types of positive pressure ventilators▫Pressure cycled▫Time cycled▫Volume cycled

Page 8: Ventilator. CONTENT… What is a ventilator? Types of ventilators Modes of ventilators Types of support Methods of ventilatory support Indications of ventilators.
Page 9: Ventilator. CONTENT… What is a ventilator? Types of ventilators Modes of ventilators Types of support Methods of ventilatory support Indications of ventilators.

Modes of ventilators…•Time cycled ventilators•Volume cycled ventilators•Pressure cycled ventilators•High Frequency Ventilators

Page 10: Ventilator. CONTENT… What is a ventilator? Types of ventilators Modes of ventilators Types of support Methods of ventilatory support Indications of ventilators.

Time cycled ventilator•Time delivery of gas flow; tidal volume =

flow rate x inspiration time•Delivers relatively constant Tidal Volume•Allows precise control of gas delivery•Types: IMV-Bird, Foregger 210, Emerson

Page 11: Ventilator. CONTENT… What is a ventilator? Types of ventilators Modes of ventilators Types of support Methods of ventilatory support Indications of ventilators.

Volume Cycled Ventilator•Inspiratory gas flow terminated after

preselected volume delivery•Pressure in circuit determined by tidal

volume and Compliance•Delivered Tidal volume changes with changes

in Compliance•Types: Bennett, Ohio 560, Bourns Bear 1,

Monaghan, Siemons Servo

Page 12: Ventilator. CONTENT… What is a ventilator? Types of ventilators Modes of ventilators Types of support Methods of ventilatory support Indications of ventilators.

Pressure cycled ventilators •Gas flow continues until preset pressure

develops•Tidal volume = flow rate x time until pressure

is reached•Variable volume if circuit pressure varies

(change in compliance)•Types: bird mark, bennett PR

Page 13: Ventilator. CONTENT… What is a ventilator? Types of ventilators Modes of ventilators Types of support Methods of ventilatory support Indications of ventilators.

High Frequency Ventilators5 types•High frequency positive pressure ventilation •Jet ventilation•Flow interruption•Oscillation•Percussive ventilation

Page 14: Ventilator. CONTENT… What is a ventilator? Types of ventilators Modes of ventilators Types of support Methods of ventilatory support Indications of ventilators.

Types of support…

•Control mode•Support mode

Page 15: Ventilator. CONTENT… What is a ventilator? Types of ventilators Modes of ventilators Types of support Methods of ventilatory support Indications of ventilators.

Control mode•In control mode, the ventilator delivers the

preset tidal volume once it is triggered regardless of patient effort

•If the patient is apneic or possesses limited respiratory drive, control mode can ensure delivery of appropriate minute ventilation

Page 16: Ventilator. CONTENT… What is a ventilator? Types of ventilators Modes of ventilators Types of support Methods of ventilatory support Indications of ventilators.

Support mode•In support mode, the ventilator provides

inspiratory assistance through the use of an assist pressure

•The ventilator detects inspiration by the patient and supplies an assist pressure during inspiration

•It terminates the assist pressure upon detecting onset of the expiratory phase

•Support mode requires an adequate respiratory drive

•The amount of assist pressure can be dialed in

Page 17: Ventilator. CONTENT… What is a ventilator? Types of ventilators Modes of ventilators Types of support Methods of ventilatory support Indications of ventilators.

Methods of Ventilatory Support…

•Continuous mandatory ventilation•Assist-control ventilation•Intermittent mandatory ventilation•Synchronous intermittent mandatory

ventilation•Pressure support ventilation•Noninvasive ventilation•Continuous positive airway pressure - CPAP

Page 18: Ventilator. CONTENT… What is a ventilator? Types of ventilators Modes of ventilators Types of support Methods of ventilatory support Indications of ventilators.

Continuous mandatory ventilation•Breaths are delivered at preset intervals,

regardless of patient effort•This mode is used most often in the paralyzed

or apneic patient Assist-control ventilation•The ventilator delivers preset breaths in

coordination with the respiratory effort of the patient

Page 19: Ventilator. CONTENT… What is a ventilator? Types of ventilators Modes of ventilators Types of support Methods of ventilatory support Indications of ventilators.

Intermittent mandatory ventilation•With intermittent mandatory ventilation

(IMV), breaths are delivered at a preset interval, and spontaneous breathing is allowed between ventilator-administered breaths

Synchronous intermittent mandatory ventilation

•The ventilator delivers preset breaths in coordination with the respiratory effort of the patient

Page 20: Ventilator. CONTENT… What is a ventilator? Types of ventilators Modes of ventilators Types of support Methods of ventilatory support Indications of ventilators.

Pressure support ventilation•For the spontaneously breathing patient,

pressure support ventilation (PSV) has been advocated to limit barotrauma and to decrease the work of breathing

Noninvasive ventilation•The application of mechanical ventilatory

support through a mask in place of endotracheal intubation is becoming increasingly accepted and used in the emergency department

Page 21: Ventilator. CONTENT… What is a ventilator? Types of ventilators Modes of ventilators Types of support Methods of ventilatory support Indications of ventilators.

Continuous positive airway pressure - CPAP▫Improves pao2 by stabilizing the airway and allowing

alveolar recruitment. CO2 retention may result from excessive CPAP

▫Most commonly, nasal CPAP prongs (also mask, nasopharyngeal, endotracheal) used to respiratory assistance in mild rds(respiratory distress syndrome), or weaning from mechanical ventilation

▫Maintains upper airway patency, so useful in apnea of infancy

▫Gastric distension may occur; place OG tube for decompression

▫2-6 cm H20 commonly used.

Page 22: Ventilator. CONTENT… What is a ventilator? Types of ventilators Modes of ventilators Types of support Methods of ventilatory support Indications of ventilators.

Indications of ventilators …•Hypercapnic respiratory failure •Hypoxemic respiratory failure•Correction of life-threatening acidemia in the

setting of salicylate intoxication•Intentional hyperventilation in the setting of major

head injury with elevated intracranial pressure•Suspicion of clinical brain herniation from any

cause•Patient in critical condition with cyclic

antidepressant toxicity

Page 23: Ventilator. CONTENT… What is a ventilator? Types of ventilators Modes of ventilators Types of support Methods of ventilatory support Indications of ventilators.

THANK YOU!!!