UNIT I
A. Introduction to Mechanical Ventilation
1. History ventilation
* Origins
* New Generations
B. Indications
1. Causes
* Acute Respiratory Failure - makes it impossible to maintain
normal oxygen uptake (O 2 ) by tissues or disposal
anhydride dioxide (CO 2 ) for them.
* Apnea - Breathing difficulty
* Hypoxemia - An abnormally low pressure
blood oxygen partial pressure.
* Hypoxia - decreased oxygen diffusion in tissues.
C. Fan Selection
1. Types of Fans
* Positive Pressure
* Types
* Mechanism of Action
2. Negative pressure - air extraction.
* Types
- Puritan Nebulizer . This can release hot steam or cold, used with a flow meter and this must be from 6 to 10 l / min can be used continuously or for treatment newspapers, providing the patient with an oxygen concentration of 40 to 100%.
- Deluxe Nebulizer Ohio. This can free cold or hot steam is used with a flow of 6 to 10 l / min. Provides an oxygen concentration of 40 to 100%.
- Disposable Nebulizer Bard-Parker U-Mid . The current flow is from 6 to 10 l / min. Provides an oxygen concentration of 35 to 100%, the majority of particles generated in a limit of 1 to 1.8 mm, which include the lower respiratory tract.
- Ultrasonic Nebulizer Bennett. turns water to the aerosol by high-frequency energy. A crystal expands and contracts as a result of the passage of electric current at a frequency of approximately at 1 350 000 times per second. The aerosol is produced by the engine vibration and drives him to the patient. If you want to be added oxygen, the amount of spray coming out of the device is 0 to 3 ml / min. With a reservoir capacity of 200 ml, this spray can be given other medications in addition to water. Masks used with other aerosol and aerosol therapy methods accepted and can be used continuously in a long-term treatment or as an intermittent.
- Top Babbington. This phenomenon is more like the mist. The water is sprayed in a thin layer of a hollow sphere. Half of it is a hole in front of the exhaust baffle or deflector plate. The gas is flowing into the area, creates pressure and exits through the opening. As the gas leaves the area, reaches supersonic speed and the liquid film breaks. Aerosol particles are broken into sizes smaller than 10 mm with a diameter of 3 to 4 mm, this device can work with oxygen or compressed air.
* Mechanism of Action
D. Types of Fans
1. Match
A. Introduction to Mechanical Ventilation
1. History ventilation
* Origins
* New Generations
B. Indications
1. Causes
* Acute Respiratory Failure - makes it impossible to maintain
normal oxygen uptake (O 2 ) by tissues or disposal
anhydride dioxide (CO 2 ) for them.
* Apnea - Breathing difficulty
* Hypoxemia - An abnormally low pressure
blood oxygen partial pressure.
* Hypoxia - decreased oxygen diffusion in tissues.
C. Fan Selection
1. Types of Fans
* Positive Pressure
* Types
* Mechanism of Action
2. Negative pressure - air extraction.
* Types
- Puritan Nebulizer . This can release hot steam or cold, used with a flow meter and this must be from 6 to 10 l / min can be used continuously or for treatment newspapers, providing the patient with an oxygen concentration of 40 to 100%.
- Deluxe Nebulizer Ohio. This can free cold or hot steam is used with a flow of 6 to 10 l / min. Provides an oxygen concentration of 40 to 100%.
- Disposable Nebulizer Bard-Parker U-Mid . The current flow is from 6 to 10 l / min. Provides an oxygen concentration of 35 to 100%, the majority of particles generated in a limit of 1 to 1.8 mm, which include the lower respiratory tract.
- Ultrasonic Nebulizer Bennett. turns water to the aerosol by high-frequency energy. A crystal expands and contracts as a result of the passage of electric current at a frequency of approximately at 1 350 000 times per second. The aerosol is produced by the engine vibration and drives him to the patient. If you want to be added oxygen, the amount of spray coming out of the device is 0 to 3 ml / min. With a reservoir capacity of 200 ml, this spray can be given other medications in addition to water. Masks used with other aerosol and aerosol therapy methods accepted and can be used continuously in a long-term treatment or as an intermittent.
- Top Babbington. This phenomenon is more like the mist. The water is sprayed in a thin layer of a hollow sphere. Half of it is a hole in front of the exhaust baffle or deflector plate. The gas is flowing into the area, creates pressure and exits through the opening. As the gas leaves the area, reaches supersonic speed and the liquid film breaks. Aerosol particles are broken into sizes smaller than 10 mm with a diameter of 3 to 4 mm, this device can work with oxygen or compressed air.
* Mechanism of Action
D. Types of Fans
1. Match
* Pressure cycled - are those in which it has control in regulating the amount of pressure that once achieved will kick off the expiratory phase.
Most of them are calibrated in cm of H2O, to establish the duration of the inspiratory phase using flow control inspiratory which is regulated in liters per minute, bearing in mind that this should not be of greater duration than the expiratory phase.
expired volume by connecting a expirometro know what the expiratory valve.
Most of them are calibrated in cm of H2O, to establish the duration of the inspiratory phase using flow control inspiratory which is regulated in liters per minute, bearing in mind that this should not be of greater duration than the expiratory phase.
expired volume by connecting a expirometro know what the expiratory valve.
* Volume cycled - In that case the determinant of the way of inspiration to expiration is the default volume. This control of inspiratory volume in turn is related to inspiratory flow regulator, which works similarly to fan pressure cycler.
allowed in a start of the expiratory phase after reaching the limit pressure. In other cycling does not occur but that escapes the current volume overload that is causing pressure, thus the
* Flow cycled - The inspiration ends when the flow inspiratory falls below a predetermined level, regardless of volume, time or pressure generated. This is the mechanism used in cycling pressure ventilation support, currently available option for most fans.
* Time cycled - In this type of fans, the transition from inspiration to expiration is determined by the controller that regulates the duration of the inspiratory time. The operation of this is independent of pressure or volume reached and its management is carried out jointly with the flow controls and inspiratory pressure limit. A fixed inspiratory time, inspiratory flow increases cause an increase in tidal volume and vice versa. By limiting inspiratory pressure in a time-cycled ventilator at the time that pressure falls below this limit will not be provided more volume to the patient, but cycling will expire only when it reaches the preset IT.
* Combined Cycle - Today, almost all the fans of combined clinical use of the above characteristics, so that the cycling is done on time, but the entry of gas achieved previously been limited to a certain pressure (pressure controlled fans) or when using the set volume (volume controlled fans.
2. Electrical and pneumatic . Characterized it comprises a tubular body which has an interior annular chamber that opens to the outside through a duct that connects the driving compressed air supply, while internally flows through a continuous annular aperture narrow width, preferably less than one ml, which is directed towards the end of the tubular body constituting the output of the fan, taking a conical configuration. an angle of preferably between 10 ° and 25 °, the tubular body extending beyond the annular chamber at both ends in a portion in which it connects, side to form the suction hose or suction driving, while the portion of the output side is mounted a filter for purifying exhaust air.
3. Fans of the New Generation
* Types
* Mechanisms of Action
*** More details in the following links; http://www.aibarra http://www.eccpn.aibarra.org/temario/seccion5/capitulo88/capitulo88.htm .org/ucip/temas/tema07/tema07.html and
* Time cycled - In this type of fans, the transition from inspiration to expiration is determined by the controller that regulates the duration of the inspiratory time. The operation of this is independent of pressure or volume reached and its management is carried out jointly with the flow controls and inspiratory pressure limit. A fixed inspiratory time, inspiratory flow increases cause an increase in tidal volume and vice versa. By limiting inspiratory pressure in a time-cycled ventilator at the time that pressure falls below this limit will not be provided more volume to the patient, but cycling will expire only when it reaches the preset IT.
* Combined Cycle - Today, almost all the fans of combined clinical use of the above characteristics, so that the cycling is done on time, but the entry of gas achieved previously been limited to a certain pressure (pressure controlled fans) or when using the set volume (volume controlled fans.
2. Electrical and pneumatic . Characterized it comprises a tubular body which has an interior annular chamber that opens to the outside through a duct that connects the driving compressed air supply, while internally flows through a continuous annular aperture narrow width, preferably less than one ml, which is directed towards the end of the tubular body constituting the output of the fan, taking a conical configuration. an angle of preferably between 10 ° and 25 °, the tubular body extending beyond the annular chamber at both ends in a portion in which it connects, side to form the suction hose or suction driving, while the portion of the output side is mounted a filter for purifying exhaust air.
3. Fans of the New Generation
* Types
* Mechanisms of Action
*** More details in the following links; http://www.aibarra http://www.eccpn.aibarra.org/temario/seccion5/capitulo88/capitulo88.htm .org/ucip/temas/tema07/tema07.html and
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