SEMINAR ON

MECHANICAL VENTILATION
Presented by-
Mr. Ajit P. Thange
First Year MSc Nursing
ANATOMY OF LUNGS

CONTENTS
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DEFINTION:

Mechanical ventilation is artificial respiration using a

mechanical ventilator to support the delivery of oxygen to
the lungs when breathing has ceased.
Functioning of ventilator:

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 Types of ventilator

KEYWORD
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Negative pressure Positive pressure

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ventilators ventilators
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 Negative pressure ventilators:

1. Iron lung:
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2. Body Wrap/ Chest Cuirass

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Positive- pressure ventilators:
1. Pressure cycled ventilators
2. Time-cycled ventilators
3. volume-cycled ventilators
4. Noninvasive positive-pressure ventilators
 Settings of Mechanical ventilator
Parameter Description
1) Respiratory rate (f) 1) Number of breaths the ventilator delivers per
minute.
2) Tidal volume (VT) 2) Volume of gas delivered to patient during each
ventilator breath.
3) Oxygen concentration (Fio2) 【 ADD
3) YOUR
Fraction TEXToxygen delivered to patient.
of inspired
4) Positive end-expiratory pressure Positive 】
4) HERE pressure applied at the end of expiration of
(PEEP) ventilator breaths.
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5) Pressure support 5) Positive pressure used to augment patient's

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inspiratory pressure.
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6) I:E Ratio 6) Duration of inspiration (I) to duration of expiration

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7) Inspiratory flow rate and time (E).

7) Speed with which the V, is delivered.
8) Sensitivity 8) Determines the amount of effort the patient must
9) High pressure limit generate to initiate a ventilator breath.
9) Regulates the maximal pressure the ventilator can
generate to deliver the Volume.
potential complications of Positive pressure ventilation:
1. Cardiovascular system:
• Alteration in cardiac output.
• Positive intrathorasic pressure causes compression of heart,
vessels.
• reduction in venous return, cardiac output.
• Hypoxia.
• Tachycardia.
• Tachypnea
2. Pulmonary system:
• Barotrauma, Pneumothorax.
• Incresed airway pressure leads to distends the lung and may
rupture alveoli.
• Air can escape into pleural space from alveoli.
• Increse in pleural pressure collapse the lung.
• Pneumomediastinum
• subcutaneous emphysema.
3. Ventilator associated pneumonia:
• Bypass to upper respiratory tract by ETT or TT.
• Poor to infection due to immobility, underlying disease, poor
nutrition.
• occurs withing 48 hours after ET intubation.
• Sputum culture grows Gram-negative bacteria.
• VAP prevention Guidelines
Head of bed elevation
Maintaining cuff pressure
Hand washing before suctioning.
4. Neurologic System:
• Impair central blood flow.
• Incresed intrathoracic positive pressure causes jugular venous
distention.
• Impaired venous return and increse in cerebral volume causes
incresed intracranial pressure
• Head of bed elevation and proper alignment of head can prevent
deleterious effect of PPV.
5. Gastrointestinal system:
• Patients are often stressed due to serious illness, immobility,
discomfort related to ventilator.
• Risk of stress ulcers and GI bleeding.
• Decreased CO may cause ischemia of gastric and intestinal
mucosa.
• Peptic ulcer prophylaxis
H2 receptor blockers- e.g ranitidine
Proton pump inhibitor- e.g Pantaprazole
Tube feeding
6. Musculoskeletal system:
• Maintainance of muscle strength.
• Adequate analgesia, Adequate nutrition.
• Passive and active exercises
• Ambulation
• Prevention of contractures, pressure ulcers, footdrops.
 Assessing the equipment
• Type of ventilator
• Controlling mode
• Tidal volume and rate settings.
• FiO2 setting
• Inspiratory pressure reached and pressure limit
• Sensitivity
• Inspiratory-to-expiratory ratio
• Water in the tubing, disconnection or kinking of the tubing
• Humidification (humidifier filled with water) and temperature
• Alarms (turned on and functioning properly)
• PEEP and pressure support level
 Nutrition
Feeding Total parentral nutrition
Care of patient receiving Mechanical Ventilation:

• Enhancing Gas exchange

• Effective airway clearance
• Preventing trauma and infection
• Promoting mobility
• Promoting optimal communication
• Promoting coping ability