Ventilation: Basic Principles Jamie Ranse Registered Nurse Emergency Department The Canberra Hospital
Anatomy and Physiology Porth CM, 1998, Pathophysiology (5 th Edn) , Lippincott, Philadelphia, USA Respiratory Structures
Anatomy and Physiology Porth CM, 1998, Pathophysiology (5 th Edn) , Lippincott, Philadelphia, USA Respiratory Zones
Anatomy and Physiology Porth CM, 1998, Pathophysiology (5 th Edn) , Lippincott, Philadelphia, USA Partitioning of Respiratory Pressures
Anatomy and Physiology Porth CM, 1998, Pathophysiology (5 th Edn) , Lippincott, Philadelphia, USA Boyles Law Increase V = Decreased P Decreased V = Increased P
Anatomy and Physiology Porth CM, 1998, Pathophysiology (5 th Edn) , Lippincott, Philadelphia, USA Respiratory Volumes and Capacity
Anatomy and Physiology perfusion without ventilation = shunt normal ventilation and perfusion ventilation without perfusion = dead space airway venous blood arterial blood Porth CM, 1998, Pathophysiology (5 th Edn) , Lippincott, Philadelphia, USA Ventilation and Perfusion
Ventilation: Basic Principles Jamie Ranse Registered Nurse Emergency Department The Canberra Hospital
Editor's Notes
Elasticity: is the return of the original shape of matter after the alteration by an outside force Compliance: is how easily a tissue is stretched, and therefore inflation of the lungs Resistance: is determined by the radius of the airway, therefore an decrease is diameter of the airway will result in an increase in resistance and therefore the amount of effort required to ventilate the patient will be increased. Pressure: the total volume of gases exert pressure against the walls of the alveoli (such as O2, NO, CO2 and other gases) Gravity: gravity effects ventilation depending on the position of patient, position of insult or injury
The conducting airways consist of the nasal passages, mouth, pharynx, larynx, trachea, bronchi, and bronchioles. Conducting Zones: the first 16 generations of branching make up the conducting airways, and the last 7 constitute the respiratory zone (or respiratory and transitional zone). BR, bronchus; BL, bronchiole; TBL, terminal bronchiole; RBL, respiratory bronchiole; AD, alveolar duct; AS, alveolar sacs.
Therefore, when there is no movement of air into or out of the lungs, alveolar and atmospheric pressures have reached an equilibrium.
Lung Volumes: Tidal Volume: volume of air inhaled and exhaled with each breath Inspiratory Reserve Volume: Maximum volume of air that can be inhaled after a normal breath Expiratory Reserve Volume: Maximum volume of air that can be exhaled after a normal breath Residual Volume: Volume of air remaining in the lungs after maximum exhalation Lung Capacities: Vital Capacity: Maximum volume of air exhaled from the point of maximum inspiration Inspiratory Capacity: Maximum volume of air inhaled after normal expiration Functional Residual Capacity: Volume of air remaining in the lungs after normal expiration Total Lung Capacity: Volume of air in the lungs after a maximum inspiration and equal to the sum of all four volumes.
Uncomfortable for the patient who is awake. Therefore not appropriate for the patient who is being weaned from the ventilator
Ventilator maintains a constant PEEP Supported ventilation is used only on spontaneously breathing patients with their own respiratory drive and therefore the ability to generate their own breath such as: pneumonia, cardiogenic pulmonary oedema, post-operative hypoxia, lung collapse, asthma ,etc…