t ed

e n tila
l l y V
n i c a s
c h a i e n t
M e P a t

By: Maddy H, Johnny A, Alana F, Chanelle C, Nathan B

Course Code: FCAR 4301
Professor: Karen Ricciuto
Due Date: March 6, 2023
 Mechanical ventilation is used as a life support that assists patients in
breathing when they cannot by pushing both air and oxygen into the
lungs. The ventilator is held at a low pressure to prevent the alveoli

Definition
from collapsing. In addition to providing oxygen, these machines
remove carbon dioxide from the lungs and reduce the amount of work
the patient would use to breathe, meaning their body can focus on
& Pathophysiology fighting off the infection. (Tobin & Manthous, 2020)

Mechanical ventilation is mainly used in acute settings for people

(Mechanically Ventilated Patients) usually in critical condition. The three causes of mechanical ventilation
are airway disease of compromise, hypoventilation, and hypoxemia.

Airway disease of compromise is when the patient has a lack of

airway protection due to trauma or an oropharyngeal infection. These
obstructions of the airway can be either proximal or distal. When it is
proximal, it includes infections such as angioedema which causes
swelling to the deeper layers of the skin. When it is distal, it includes
respiratory diseases such as asthma or acute exacerbation of the
chronic obstructive pulmonary disease.

Hypoventilation is the inability of the body to do gas exchange

resulting in hypercapnic respiratory failure. This can be caused by
respiratory muscle weakness such as muscular dystrophy, peripheral
nervous system defects such as Guillain-Barre Syndrome, and
restrictive ventilatory defects such as chest wall trauma or
pneumothorax.

Hypoxemic respiratory failure is the inability to exchange oxygen to

the peripheral tissues due to alveolar filling defects such as
pneumonia or diffusion defects such as advanced pulmonary fibrosis.
(Hickey & Giwa, 2022)
 Indications for Mechanical Ventilation:

How Mechanically -
-
Abnormally slow breathing (Bradypnea)
Cessation of breathing (Apnea)

Ventilated Patients might

- Abnormally rapid breathing (Tachypnea)
- Inefficient gas exchange in the lungs
- Respiratory muscle fatigue
present - Experiencing Hypoventilation or Hypoxemia

Who needs Mechanical Ventilation?

- Short-term ventilation while being under general anesthesia for

a surgical procedure
- Severe heart disease
- Acute lung injury (infection)
- Hypotension
- Coma patients
- Sepsis and multiorgan failure
- Neuromuscular Diseases
- Acute Asthma
- Chronic Obstructive Pulmonary Disease (COPD)
- Acute Respiratory Distress Syndrome (ARDS)
- Mechanical Ventilation might also be used in patients who have
- been diagnosed with West Nile Virus. SARS and COVID-19 (Shiel.
JR, 2020)
 2 Most common types of Ventilation:

Types of Mechanical
1. Positive- Pressure Ventilation, PPV ( #1 Most Common)
- It is known as “conventional mechanical ventilation”

Ventilation
when someone mentions “they are on a ventilator” this
is the type they are referring to.
- It operates by using positive pressure that is greater than
the atmospheric pressure to push air into the lungs. The
air then fills the alveoli, where the exchange of oxygen
and carbon dioxide take place.
- Most commonly used to treat Sleep Apnea.
-
2. Negative- Pressure Ventilation (NPV)
- This type is not as common, it operates by generating
negative pressure outside the thoracic cavity and it is less
than the atmospheric pressure. Air moves from an area
of higher pressure outside the body to a lower pressure
inside the lungs .(Landry, 2023)

Examples of NPV

Iron Lung- A negative-pressure ventilator that was invented in

the 1920’s. Used primarily to treat patients with POLIO

Cuirass Ventilation- Delivered through a tight-fitting garment

that covers the chest and abdomen. (J.Landry, 2023)
Medical
Management/treatment &
role of OTA/PTA
(Mechanically Ventilated Patients)
Medical Management/treatment
Mechanically ventilated patients require frequent use of drugs
such as sedation and analgesia (Kress, John P, 2006). Analgesia is
used first to relieve the pain while sedation is then used to relieve
anxiety (Saito Masataka, 2003). The use of these substances have
shown to optimize short- and long-term outcomes in
mechanically ventilated patients (Kress, John P, 2006).
● Most common sedation drugs are Propofol, Midazolam, &
Dexmedetomidine (Diederik Gommers, 2008)
● Most common analgesia drugs are Fentanyl & Morphine
(Diederik Gommers, 2008)
Role of OTA/PTA
● Education
● Transfers
● Exercise
● Bed positioning to prevent weakness of muscle strength &
endurance, skin deterioration, pressure sores
● Check vitals signs (RR = <30, HR = <130 bpm, Sp02 = >88%)
(Niranjani Prasad, 2017)
Interactive
Activity https://kahoot.it/challenge/031
8373?challenge-id=17bc0308-
(Kahoot)
64e9-4eb3-b629-9f625884884
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 https://my.clevelandclinic.org/health/treatments/15368-mechanical-ventilation

Cynthia Alexander (May 08, 2021) Moving Patients from Bed to wheelchair, Staff ed. Retrieved

References March 5th 2023, from

https://www.mountnittany.org/wellness-article/moving-patients-from-bed-to-wheelchair-staff-ed

(Information) Dreamtime (2023) Pain Relief stock illustration. Retrieved March 5th 2023, from
https://www.dreamstime.com/stock-photos-pain-relief-image24572553

Diederik Gommers (May 2008) Medication for analgesia and sedation in the intensive care unit: an
overview. Retrieved March 4th 2023, from
https://ccforum.biomedcentral.com/articles/10.1186/cc6150

Hickey, S. M., & Giwa, A. O. (2022, November 26). Mechanical Ventilation. Retrieved March 4, 2023,
from https://pubmed.ncbi.nlm.nih.gov/30969564/

Kress, John P (October 2006) Sedation in the mechanically ventilated patient. Retrieved March 4th
2023, from
https://journals.lww.com/ccmjournal/Abstract/2006/10000/Sedation_in_the_mechanically_ventilated_
patient.4.aspx

Landry , J. (2023, January 28). Mechanical ventilation made easy: Ventilator basics (2023).
Mechanical Ventilation. Retrieved March 4, 2023, from
https://www.respiratorytherapyzone.com/mechanical-ventilation-made-easy/#:~:text=Types%20of%2
0Mechanical%20Ventilation%201%20Positive-Pressure%20Ventilation%20Positive-pressure,Invasiv
e%20Mechanical%20Ventilation%20...%204%20Noninvasive%20Ventilation%20

Niranjani Prasad (April 20th, 2017) A reinforced learning approach to weaning of mechanical
ventilation in intensive care units. Retrieved March 4th 2023, from
https://arxiv.org/pdf/1704.06300.pdf

Pingitem (n.d.) Vital Signs Clipart. Retrieved March 5th 2023, from
https://www.pngitem.com/middle/iRJwxho_vital-signs-clipart-hd-png-download/
References
Saito Masataka (March 2003) Sequential Use of Midazolam and Propofol for Long-Term
Sedation in Postoperative Mechanically Ventilated Patients. Retrieved March 4th 2023,
from
https://journals.lww.com/anesthesia-analgesia/Fulltext/2003/03000/Sequential_Use_of_
(Information) Midazolam_and_Propofol_for.35.aspx

Shiel. JR, W. C. (2020, March 30). Who needs mechanical ventilation (breathing
machine)? MedicineNet. Retrieved March 5, 2023, from
https://www.medicinenet.com/who_needs_mechanical_ventilation/article.htm

Tobin, M., & Manthous, C. (2020, April). Mechanical Ventilation . thoracic.org . Retrieved
March 4, 2023, from
https://www.thoracic.org/patients/patient-resources/resources/mechanical-ventilation.pdf