A presentation slide made for the course Clinical Engineering for Bio-medical Engineering students. For educational purpose only.

1. VENTILATOR
MACHINE
Hasibul Hasan Hredoy

2. DEFINITION
A ventilator is a machine designed to provide Mechanical
ventilation by moving breathable air into and out of the
lungs, to deliver breaths to a patient who is physically
unable to breathe or breathing insufficiently

3. FIG:
PORTABLE
VENTILATOR

4. POSSIBLE USERS
•COPD
•Undergoing surgery
•Acute lung injury
•Apnea with respiratory arrest
•Stoke/ brain injury

5. HISTORY
• 1928 Iron Lung
•1930 – 1950 Negative pressure devices
•1950 Ventilator using positive pressure
source

6. Type Of Ventilators
Transport ventilators
Intensive-care ventilators
Neonatal ventilators
Positive airway pressure
ventilators

7. COMPONENTS

10. PRINCIPAL OF OPERATION
Ventilators blow air or air with extra oxygen into the airways and then the
lungs. The airways are pipes that carry oxygen-rich air to your lungs. They
also carry carbon dioxide, a waste gas, out of your lungs.
The airways includes:
1. Nose and linked air passages, called nasal cavities
2. Mouth
3. Larynx or voice box
4. Trachea or windpipe
5. Tubes called bronchial tubes or bronchi and their branches

11. The Breathing Tube
A ventilator blows air into your airways through a breathing tube. One end of
the tube is inserted into the windpipe and the other end is attached to the
ventilator. The process of inserting the tube into the windpipe is called
intubation. Usually, the breathing tube is put into the windpipe through your
nose or mouth. The tube is then moved down into the throat. A tube placed
like this is called an endotracheal tube.
In an emergency, you're given medicine to make you sleepy and ease the pain
of the breathing tube being put into the windpipe. An endotracheal tube is held
in place by tape or with an endotracheal tube holder. This holder often is a
strap that fits around the head.
Sometimes the breathing tube is placed through a surgically made hole called a
tracheostomy . The hole goes through the front of the neck and into windpipe.
The tube put into the hole sometimes is called a "trach" tube.
The procedure to make a tracheostomy usually is done in an operating room.
Specially made ties or bands that go around the neck hold the trach tube in
place.
For the most part, endotracheal tubes are used for people who are on

13. The Ventilator
Positive pressure breaths from the ventilator are typically delivered through
an endotracheal tube or a tracheostomy tube. During each positive-pressure
breath, the lungs expand in proportion to the volume of gas delivered until
a preset pressure, volume, or time limit is reached. A valve then opens to
relieve pressure in the lungs, allowing the patient to passively exhale.
A critical care ventilator typically consists of a flexible breathing circuit, a
control system, a gas supply, and monitors and alarms.

15. HOW IT IS DONE

16. BLOCK
DIAGRAM

17. MODES
Each mode is different in determining how much work of breathing the
patient has to do.
Volume mode:
• 1. CMV or CV
• 2. AMV or AV
• 3. IMV
• 4. SIMV

18. PRESSURE MODE
1- Pressure-controlled ventilation (PCV)
2- Pressure-support ventilation (PSV)
3- Continuous positive airway pressure (CPAP)
4- Positive end expiratory pressure (PEEP)
5- Noninvasive bilevel positive airway pressure ventilation
(BiPAP)

19. CONTROL MODE
Delivers pre-set volumes at a pre-set rate and a pre-set flow rate.
The patient Can’t generate spontaneous breaths, volumes, or flow
rates in this mode.

20. ASSIST CONTROL MODE
•Delivers pre-set volumes at a pre-set rate and a pre-set flow rate.
•The patient CANNOT generate spontaneous volumes, or flow rates in this
mode.
•Each patient generated respiratory effort over and above the set rate are
delivered at the set volume and flow rate.

22. SYCHRONIZED INTERMITTENT
MANDATORY VENTILATION
(SIMV)
oDelivers a pre-set number of breaths at a set volume and
flow rate.
oAllows the patient to generate spontaneous breaths,
volumes, and flow rates between the set breaths.
oDetects a patient’s spontaneous breath attempt and
doesn’t initiate a ventilatory breath – prevents breath
stacking

23. SIMV
 Machine breaths:
- Delivers the set volume or pressure
Patient’s spontaneous breath:
-Set pressure support delivered
 Mode of ventilation provides moderate amount of support
 Works well as weaning mode

27. PRESSURE REGULATED VOLUME
CONTROL
• This is a volume targeted, pressure limited mode. (available in
SIMV or AC)
• Each breath is delivered at a set volume with a variable flow rate
and an absolute pressure limit.
• The vent delivers this pre-set volume at the LOWEST required
peak pressure and adjust with each breath.

28. PRESSURE REGULATED VOLUME
CONTROL
A control mode, which delivers a set tidal volume with each breath at
the lowest possible peak pressure. Delivers the breath with a
decelerating flow pattern, which is less harmful to lung.

30. POSITIVE END EXPIRATORY PRESSURE
(PEEP):
• This is NOT a specific mode but is rather an adjunct to any of the
vent modes.
• PEEP is the amount of pressure remaining in the lung at the END
of the expiratory phase.
• Utilized to keep otherwise collapsing lung units open while
hopefully also improving
oxygenation.
• Usually, 5-10 cmH2O

31. CONTINUOUS POSITIVE AIRWAY
PRESSURE
(CPAP):
• This is a mode and simply means that a preset pressure
is present in the circuit and lungs throughout both the
inspiratory and expiratory phases of the breath.
• CPAP serves to keep alveoli from collapsing, resulting in
better oxygenation.

32. COMBINATION MODE
Combination modes combine features of pressure and
volume targeting to accomplish ventilatory objectives
which might not be fulfilled by either used independently.
Combination modes are pressure targeted, partial support
is generally provided by pressure support and full support
is provided by Pressure Control.

34. PROBLEMS & SOLUTION
Problems Solutions
Risk of acquiring ventilator associated
pneumonia (VAP).
Following proper infection control
procedures in maintaining the ventilator,
breathing circuit, artificial airway, and all
associated equipment can minimize patient
risk.
Leak in breathing circuit and it’s component. Ventilator should signal an alarm if leakage
occurs.
Patient fighting the ventilator. Proper maintenance and avoiding operator
error or machine failure can reduce the risk.

35. PPM

36. PURCHASE CONSIDERATION
•should offer assist/control and SIMV modes.
•It should also provide CPAP/PEEP and pressure support. The unit
should monitor airway pressure, respiratory rate, I:E ratio, and minute
volume; controls should be available for ventilator mode, pressure
level, tidal volume, respiratory rate, flow rate FiO2, PEEP/CPAP, I:E ratio,
pressure support, and trigger sensitivity
•Alarms, both visual and auditory, should be available for airway
pressure, low CPAP/PEEP, minute volume , respiratory rate , gas supply
loss, and power failure.
•Should include O2 Analyzer.
•Clearly Identifiable controls and their functions.

37. CONTINUE
•Maintenance Costs
•Environmental Consideration
•Good human factor design

38. MANUFACTURER
•Acoma Medical Industry Co Ltd
•Air Liquide Medical Systems France
•Bio-Med Devices Inc
•CareFusion Respiratory
•Covidien Nellcor
•Draeger Medical Inc

40. This Photo by Unknown Author is licensed under CC BY-SA-NC

41. REFERENCES:
https://doi.org/10.1016/j.compbiomed.2018.04.016 (journal)