MECHANICAL VENTI ANDOXYGEN DLATORS MECHANICAL VENTILATORS DEFINITION MECHANICAL VENTILATOR IS A POSITIVE NEGATIVE PRESSURE BREATHING DEVICE THAT CAN MAINTAIN VENTILATIONELIVERY FOR A PROLONGED PERIO.
MECHANICAL VENTILATORS DEFINITION MECHANICAL VENTILATOR IS A POSITIVE / NEGATIVE PRESSURE BREATHING DEVICE THAT CAN MAINTAIN VENTILATION ANDOXYGEN DELIVERY FOR A PROLONGED PERIOD ANATOMY AND PHYSIOLOGY OXYGEN DISSOCIATION CURVE INDICATIONS A) RESPIRATORY FAILURE (1) PaO250mmHg B) CNS DISORDERS (1) OVERDOSE OF SEDATIVES (2) CVA (3) GUILLAIN BARRE SYNDROME INDICATIONS( CONTD) C) MUSCULO SKELETAL & PLEURAL-FUNCTION (1)KYPHOSCOLIOSIS (2)FLAIL CHEST (3)PLEURAL EFFUSION (4)PNEUMO/HAEMOTHORAX D) CONDUCTIVE DISORDER (1)UPPER AIRWAY OBSTRUCTION (2)EPIGLOTTITIS (3)SLEEPAPNOEA (4)ASTHMA (5)BRONCHOSPASM CONTD… E) DISORDER OF GAS EXCHANGE (1)PNEUMONEA (2)PULMONARY OEDEMA (3)ARDS (4)ASPIRATION (5)CYSTIC FIBROSIS (6)SMOKE INHALATION F)NEONATALCONDITIONS (1)HYALINE MEMBRANE DEFICIENCY (2)MECHONIUM ASPIRATION (3)PRETERM LABOUR TYPES OF MECHANICAL VENTILLATORS NEGATIVE PRESSURE VENTILATOR • IRON LUNG BODYWRAP / PNEUMOWRAP / TORTOISE SHELL POSITIVE PRESSURE VENTILATORS •Inflate the lungs by exerting positive pressure on the airway, forcing alveoli to expand during inspiration •Expiration occurs passively TYPES OF POSITIVE-PRESSURE VENTILLATORS • PRESSURE-CYCLED • TIME CYCLED • VOLUME CYCLED • NON INVASIVE POSITIVE PRESSURE Eg: BIPAP MEDLEY OF MODES • CONTROLLED MANDATORY VENTILATION • ASSIST CONTROLLED MODE • INTER MITTENT MANDATORY VENTILATION • SYNCHRONIZED INTERMITTENT MANDATORY VENTILATION • PRESSURE SUPPORT VENTILATION CPAP/PEEP BiPAP T-piece SIGH-a life saver PROBLEMS WITH MECHANICAL VENTILATION • PROBLEM Increase in peak air way pressure • CAUSES Coughing Bucking Decreased lungcompliance Tubing kinked Pneumo thorax Atelectasis PROBLEMS WITH MECHANICAL VENTILATION - contd Decrease in pressure / loss of volume Increase in compliance Leak in ventilator / tube / humidifier PROBLEMS WITH MECHANICAL VENTILATION – contd • PATIENT Cardiovascular- compromise Barotrauma/ pneumothorax Pulmonary infection Decreased in venous return High mean airway pressure lead to alveolar rupture Bypass of normal defense mechanism BUCKING THE VENTILATOR Its management CAUSES Anxiety Hypoxia Increased secretion Hypercapnia Pulmonary edema MANAGEMENT FOR BUCKING • Muscle relaxant • Tranquilizers • Analgesics • Paralyzing agent NURSING MANAGEMENT Enhancing gas exchange Promoting effective airway clearance Preventing trauma and infection Promoting optimal level of mobility Promoting optimal communication Promoting coping ability RESPIRATORY WEANING CRITERIA VITAL CAPACITY -10-5-15ml/kg MAXIMUM INSPIRATORY PRESSURE = -20mm of WATER TIDAL VOLUME =7-9ml/kg MINUTE VENTILATION -6Liter/minute PAO2 >60mm of hg STABLE VITAL SIGNS AND ABG STEPS OF WEANING Volume control mode SIMV CPAP T-piece Mask ... ASPIRATION (3)PRETERM LABOUR TYPES OF MECHANICAL VENTILLATORS NEGATIVE PRESSURE VENTILATOR • IRON LUNG BODYWRAP / PNEUMOWRAP / TORTOISE SHELL POSITIVE PRESSURE VENTILATORS •Inflate the lungs by exerting... PROBLEMS WITH MECHANICAL VENTILATION • PROBLEM Increase in peak air way pressure • CAUSES Coughing Bucking Decreased lungcompliance Tubing kinked Pneumo thorax Atelectasis PROBLEMS WITH MECHANICAL. ..DEFINITION MECHANICAL VENTILATOR IS A POSITIVE / NEGATIVE PRESSURE BREATHING DEVICE THAT CAN MAINTAIN VENTILATION