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The Mechanical Ventilator

The Mechanical Ventilator

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Published by John Alcantara
about mechanical ventilator
about mechanical ventilator

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Categories:Types, Presentations
Published by: John Alcantara on Oct 05, 2013
Copyright:Attribution Non-commercial


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Mechanical ventilator is a positive- or negative-pressure breathing device that can maintain ventilation and oxygen delivery for a prolonged period.

     PaO2 50 mm Hg with FiO2 0.25 Vital capacity 2 times tidal volume Negative inspiratory force 25 cm H2O Respiratory rate 35/min .60 PaO2 50 mm Hg with pH 7.

 Negative-Pressure Ventilators ◦ Iron Lung (Drinker Respirator Tank) ◦ Body Wrap (Pneumo-Wrap) ◦ Chest Cuirass (Tortoise Shell)  Positive-Pressure Ventilators ◦ ◦ ◦ ◦ Pressure-Cycled Ventilators Time-Cycled Ventilators Volume-Cycled Ventilators Noninvasive Positive-Pressure Ventilation .

. filling its volume.  Decreasing the intrathoracic pressure during inspiration allows air to flow into the lung. Negative-pressure ventilators exert a negative pressure on the external chest.

 It was used extensively during polio epidemics in the past and currently is used by a few polio survivors and patients with other neuromuscular disorders .

these types of ventilators are used only with carefully selected patients. Portable devices that require a rigid cage or shell to create a negative-pressure chamber around the thorax and abdomen.  . Because of problems with proper fit and system leaks.

pushing air in.  . forcing the alveoli to expand during inspiration. similar to a bellows mechanism. inflate the lungs by exerting positive pressure on the airway. These ventilators are widely used in the hospital setting and are increasingly used in the home for patients with primary lung disease.

. and expiration occurs passively. and then cycles off. delivers a flow of air (inspiration) until it reaches a preset pressure.

The volume of air the patient receives is regulated by the length of inspiration and the flow rate of the air. . terminate or control inspiration after a preset time.

 . Once this preset volume is delivered to the patient. the ventilator cycles off and exhalation occurs passively. Most commonly used The volume of air delivered with each inspiration is preset.

 A method of positive-pressure ventilation that can be given via face masks that cover the nose and mouth. or other oral or nasal devices . nasal masks.

 refers to how breaths are delivered to the patient.  The most commonly used modes are: ◦ Assist–control ◦ Intermittent Mandatory Ventilation ◦ Synchronized Intermittent Mandatory Ventilation ◦ Pressure Support Ventilation ◦ Airway Pressure Release Ventilation .

 provides full ventilatory support by delivering a preset tidal volume and respiratory rate. .

. provides a combination of mechanically assisted breaths and spontaneous breaths.

 delivers a preset tidal volume and number of breaths per minute. Between ventilator-delivered breaths. the patient can breathe spontaneously with no assistance from the ventilator on those extra breaths.  .

Pressure support is reduced gradually as the patient’s strength increases.  . applies a pressure plateau to the airway throughout the patienttriggered inspiration to decrease resistance within the tracheal tube and ventilator tubing.

The inflation period is long. pressure-limited. timecycled mode of mechanical ventilation that allows unrestricted.  . and breaths may be initiated spontaneously as well as by the ventilator. spontaneous breathing throughout the ventilatory cycle. a time triggered.


volume-cycled. synchronized intermittent mandatory ventilation) Tidal volume and rate settings (tidal volume is usually set at 6 to 12 mL/kg [ideal body weight]. Type of ventilator (eg. rate is usually set at 12 to 16 breaths/min)  . controlled ventilation. negative-pressure)  Controlling mode (eg. assist–control ventilation. pressurecycled.

this increases if there is increased airway resistance or decreased compliance) Sensitivity (a 2-cm H2O inspiratory force should trigger the ventilator) Inspiratory-to-expiratory ratio (usually 1:3 [1 second of inspiration to 3 seconds of expiration] or 1:2)   . FiO2 setting Inspiratory pressure reached and pressure limit (normal is 15 to 20 cm H2O.

if applicable Water in the tubing.5 times the tidal volume and ranging from 1 to 3 per hour). disconnection or kinking of the tubing   . usually 6 to 8 L/min) Sigh settings (usually set at 1. Minute volume (tidal volume respiratory rate.

if applicable (PEEP is usually set at 5 to 15 cm H2O)  Alarms  PEEP . Humidification (humidifier filled with water) and temperature (turned on and functioning properly) and pressure support level.


.If the ventilator system malfunctions and the problem cannot be identified and corrected immediately. the nurse must ventilate the patient with a manual resuscitation bag until the problem is resolved.


 Coughing or plugged airway tube  Patient ◦ Suction airway for secretions. empty condensation fluid from circuit “bucking” ventilator  Decreasing ◦ Adjust sensitivity lung compliance ◦ Manually ventilate patient .

 Increase in compliance ◦ None  Leak in ventilator or tubing. cuff on tube/ humidifier not tight ◦ Check entire ventilator circuit for patency ◦ Correct leak .

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