This document discusses mechanical ventilators, including: 1) It describes the parts of a ventilator and different modes of ventilation, including non-invasive modes like BiPAP and CPAP, and invasive modes like volume control, pressure control, and PRVC. 2) It provides guidelines for initial ventilator setup and adjustment based on a patient's predicted body weight and goals of avoiding injury while recruiting alveoli. 3) It covers advantages of non-invasive ventilation over invasive intubation, as well as potential complications, contraindications, and choices of ventilation mode.

1. BASIC KNOWLEDGE ABOUT
VENTILATOR MACHINE
DR MAYURESH PAREEK
Assistant Professor
Department of Anaesthesiology
PDUMC, Rajkot

2. OBJECTIVES
• Parts of ventilator
• Non invasive mode of ventilation
• Invasive mode of ventilation
• Supportive care
• Weaning

6. •Mechanical ventilator is an apparatus which can
replace normal mechanism of breathing either
by providing intermittent or continuous flow of
oxygen or air under pressure ,which is
connected to the patient by a tube inserted
through mouth ,the nose or an opening in the
trachea

8. GOALS OF MECHANICAL VENTILATION
• Avoiding extension of lung injury,
• ↓O2 toxicity
• Recruiting alveoli by ↑ mean Paw by ↑
PEEP and/or prolonging inspiration,
• ↓ Peak Paw
• Preventing atelectasis
• Using sedation and paralysis judiciously
• Better Patient-Ventilator synchrony
• If the patient deteriorates on niv then invasive ventilation with
definitive airway has to be started

9. INITIAL SETUP
• Position
• Head of the bed at a 45°
angle
• Mask
• Choose correct size mask
• Connect mask to ventilator
• Pulse Oximeter
• Avoid nasogastric tube

10. VENTILATOR SETUP AND ADJUSTMENT
• 1. Calculate predicted body weight (PBW)
Males = 50 + 2.3 [height (inches) - 60]
Females = 45.5 + 2.3 [height (inches) -60]
• 2. Select appropriate ventilator mode
• 3. Set ventilator settings to achieve initial VT = 8 ml/kg PBW
• 4. Reduce VT by 1 ml/kg at intervals ≤ 2 hours until VT =
6ml/kg PBW.
• 5. Set initial rate to approximate baseline minute ventilation
(not > 35 bpm).
• 6. Adjust VT and RR to achieve pH and plateau pressure goals

11. MODE
•Mode is a method or way a breath is delivered
•TYPES OF NON INVASIVE MODE
1.BIPAP MODE
2.C PAP MODE
TYPES OF INVASIVE MODE
1.Controlled
2.Supporitive
3.Combination

14. CONTROLLED MODES
•Every breath delivered to patient is a
mechanical breath
•Breath may be triggered by a timing mechanism
or patient effort
1.Volume control
2.Pressure control
3.PRVC

15. SUPPORTED MODE
•Every breath is spontaneous
•Patient triggered and patient cycled
1.Volume support
2.Pressure support /CPAP

16. COMBINATION MODES
•Combination of both controlled and supported
1.SIMV(VC)+PS
2.SIMV (PC)+PS
3.SIMV (PRVC)+PS

17. ADVANTAGES OF NIV
• Avoids ETT-associated complication
• Flexibility in initiating and removing MV
• Decrease the need for invasive monitoring
• Decreases sedation requirements
• Ventilates effectively at lower pressures

18. COMPLICATIONS AND SIDE EFFECTS OF NIV
• Conjunctival irritation / conjunctivitis
• Mouth or nasal dryness
• Sinus pain or ear pain
• Nasal congestion
• Gastric insufflation
• ‘Claustrophobia’
• Nasal bridge irritation or ulceration
• Aspiration pneumonia

19. CONTRAINDICATIONS
• 1. Respiratory arrest
• 2. Medically unstable
• 3. Unconscious, unable to protect airways
• 4. Excessive secretions
• 5. Significant vomiting
• 6. Agitated or uncooperative
• 7. Facial trauma, burns, surgery or anatomic
• abnormalities interfering with mask application
n

20. CHOICE OF MODE

21. THANK YOU