Mechanical ventillation

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Mechanical ventillation

  1. 1. MECHANICALVENTILATION BY P. ARUL VALAN
  2. 2. DEFINITIONA mechanical ventilator is a positive or a negative pressure breathing device that can maintain ventilation and oxygen delivery for a prolonged period.
  3. 3. INDICATIONS• Acute lung injur y.• Apnea with respirator y ar rest.• COPD.• Acute respir ator y acidosis.• Hypoxemia.
  4. 4. TERMINOLOGIES• Tidal volume ( vt )• Inspiratory reserve volume ( IRV )• Expiratory reserve volume (ERV )• Residual volume ( RV )• Vital capacity ( Vc )• Inspiratory capacity ( IC )• Functional residual capacity ( FRC )• Total lung capacity ( TLC )• Minute volume
  5. 5. CLASSIFICATION OFVENTILATORS NEGATIVE PRESSURE VENTILATOR. POSITIVE PRESSURE VENTILATOR.
  6. 6. NEGATIVE PRESSUREVENTILATOR
  7. 7. THE IRON LUNG
  8. 8. POSITIVEPRESSUREVENTILATOR INFLATES THE LUNG BY EXERTING POSITIVE PRESSURE ON THE AIRWAY FORCING ALVEOLI TO EXPAND DURING INSPIRATION AND EXPIRATION OCCURS PASSIVELY.
  9. 9. TYPES• PRESSURE CYCLED • VOLUME CYCLED • TIME CYCLED
  10. 10. PRESSURE CYCLED ENDS INSPIRATION WHEN A PRESET PRESSURE HAS BEEN REACHED. THE PRESSURE APPLIED TO THE AIRWAY IS CONSTANT. VOLUME OF AIR VARY AS PATIENTS AIRWAY RESISTANCE CHANGES. THEY ARE ALSO TIME CYCLED ( BREATHS ARE GIVEN AT FIXED INTERVALS )
  11. 11. VOLUME CYCLED THE VOLUME OF AIR DELIVERED TO THE PATIENT AT EACH INSPIRATION IS PRESET . ONCE THE PRESET VOLUME IS DELIVERED THE VENTILATOR CYCLES OFF AND EXHALATION OCCURS PASSIVELY. VOLUME OF AIR DELIVERED IS CONSTANT DESPITE VARYING PRESSURE.
  12. 12. TIME CYCLED ENDS INSPIRATION AFTER THE PRESET TIME. VOLUME OF AIR THE PATIENT RECIEVES IS REGULATED BY THE LENGTH OF INSPIRATION AND THE FLOW RATE.
  13. 13. OTHERS INVASIVE VENTILATION . NON INVASIVE VENTILATION. FULL VENTILATION. PARTIAL VENTIATION.
  14. 14. VENTILATOR SETTINGS TIDAL VOLUME.6 TO 8 ml/KgPredicted body weight :MALE : 50+2.3 X { Ht – 60 }FEMALE : 45.5+2.3 X { Ht – 60 }6ml/Kg : ARDS6 to 8ml/Kg : OBSTRUCTED LUNG DISEASE8 to 10ml/Kg :NEUROMUSCUL AR DIEASE
  15. 15. RESPIATORY RATE 15 TO 25 /min TO ACHIEVE A MINUTE VOLUME OF 7 TO 10 L/min. LOWER RR PREVENTS AIR TRAPPING.
  16. 16. I:E RATIO,Fio2I:E RATIO IS 1:2START Fio2 WITH 1 . O ANDREUCE IT TO 0.6TITRATE USING PULSEOXYMETRY.
  17. 17. What is the extent of the What is the patient chest patients lung injury? wall (Cw) compliance? NORMAL Target PaO2>60-80 LOW -obesity What FiO2 is required to -edema achieve this? -abdominal hypertension Normal Cw Compliance Low Cw Compliance FiO2 PEEP in cmH2O PEEP in cmH2O 0.3 5 10 0.4 8 12 0.5 10 14 0.6* 12 16 0.7* 14 18 0.75* 16 20 0.8* 18 22 0.9* 20 22 1* 22 24
  18. 18. MODES OF VENTILATOR CONTROLED VENTILATION PRESET VOLUME OF AIR IS DELIVERED UNDER POSITIVE PRESSURE. SPONTANEOUS PATIENT RESPIRATION IS LOCKED OUT.
  19. 19. ASSIST CONTROL VENTILATION ALLOWS PATIENT TO INTIATE MECHANICAL BREATH BUT CAN ALSO DELIVER A PRESET LEVEL OF MINUTE VENTILATION IF THE PATIENT CANNOT TRIGGER. PATIENT IS FULLY RESTED ON THE VENTILATOR AND CAN BREATH SPONTANEOULY WITHOUT WORKING.
  20. 20. ASSIST CONTROL VETILATION
  21. 21. SIMV MODE• GAS FLOWS IN THE SIMV MODE .A PRESET MINIUM NUMBER OF BREATHS ARE DELIVERED TO THE PATIENT BUT THE PATIENT ALSO TAKES SPONTANEOUS BREATHS OF VARIOUS VOLUMES.
  22. 22. SYNCHRONIZEDINTERMITENT MANDATORYVENTILATION
  23. 23. PRESSURE SUPPORT VENTILATION
  24. 24. IMV CONTROLLED BREATH
  25. 25. IMV SPONTANEOUS BREATH
  26. 26. SYNCHRONIZED INTERMITENT MANDATORY VENTILATION
  27. 27. SENSOR MEDICS 3100 A
  28. 28. SEIMON SERVO 900C
  29. 29. DRAGER BABYLOG 8000

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