Physiology of Ventilatory

Support
By Urooba Syed (BS anesthesia
and critical care – 8th semester)
Learning objectives
• Understand the basics of respiratory physiology.
• Identify respiratory failure.
• Comprehend the principles of ventilatory support.
• Analyze indications for ventilatory support.
• Examine the physiological effects of ventilatory support.
Introduction
• Ventilatory support is a crucial intervention in managing respiratory
failure.
• Ventilatory support isn’t just about machines and tubes; it’s about
the resilience of the human spirit, the tireless efforts of healthcare
professionals, and the miracles that modern medicine can achieve.
• This presentation explores the physiology behind ventilatory
support.
Respiratory System Overview
• The respiratory system's primary function is gas exchange: oxygen
in, carbon dioxide out.
• Lungs and airway(trachea, bronchi, aveoli) play key roles.
• Essential respiratory muscles, particularly includes the diaphragm
and intercostal muscles.
• Gas exchange primarily occurs in the tiny air sacs called alveoli
within the lungs.
• Oxygen is absorbed from the alveoli into the bloodstream, and
carbon dioxide is removed from the blood and expelled into the
alveoli for exhalation.
• Respiratory system's overall purpose is to ensure the body receives
the oxygen it needs while getting rid of excess carbon dioxide,
crucial for maintaining bodily functions and survival.
Lung Compliance
• Lung compliance (C) is defined as the change in lung volume (ΔV)
per unit change in transpulmonary pressure (ΔP): C= ΔP/ΔV
• It refers to the ability of the lungs to expand and stretch when air is
inhaled and to recoil when air is exhaled.

• Transpulmonary pressure, which is the difference between the

airway pressure (Paw) and the intrapleural pressure.
Static vs Dynamic compliance
• Definition: Static compliance, measures the distensibility or
stretchability of the lungs and chest wall when there is no airflow
(e.g., during a pause in ventilation).

• Definition: Dynamic compliance, measures the distensibility or

stretchability of the lungs and chest wall during active ventilation,
specifically during the respiratory cycle (i.e., during inspiration and
expiration).
PEEP (Positive End-Expiratory Pressure)
• PEEP is a positive pressure applied to the airway at the end of the
expiratory phase of mechanical ventilation, it prevents alveoli from
collapse.
• Improves oxygenation and lung recruitment.
• PEEP is especially useful in patients with conditions like acute
respiratory distress syndrome (ARDS) or pneumonia, where
hypoxemia (low blood oxygen levels) is a concern. It can help raise
oxygen levels in the blood.
• Too much PEEP can cause barotrauma (lung injury due to excessive
pressure)
Ventilation-Perfusion (V/Q) Matching
• Ventilation-Perfusion (V/Q) mismatch is a term used in respiratory
physiology to describe an imbalance between two essential
processes: ventilation and perfusion, which are necessary for
efficient gas exchange in the lungs.
• 1. Dead Space: there is adequate ventilation (air reaching the
alveoli), but little or no perfusion (blood flow) in the surrounding
pulmonary capillaries.
• 2. Shunt: his situation involves adequate perfusion (blood flow) to
an area of the lung but limited or no ventilation (air reaching the
alveoli) in the same area.
Respiratory failure
• Respiratory failure is a condition in which the respiratory system
fails to adequately perform its essential functions, primarily
oxygenating the blood and removing carbon dioxide. It can be
categorized into two main types:
• Acute Respiratory Failure: For example; Hypoxemic Respiratory
Failure, Hypercapnic Respiratory Failure.
• Chronic Respiratory Failure: For example; Chronic Obstructive
Pulmonary Disease (COPD), Interstitial Lung Disease (ILD).
Physiological goals of ventilatory support
• Maintain adequate oxygenation (PaO2) and effective ventilation
(PaCO2).
• Lung Protection: Ventilatory support should minimize the risk of
lung injury, including barotrauma and volutrauma.
• Relief of Respiratory Distress
• Prevention of Atelectasis and optimization of lung compliance.
• Correction of Ventilation-Perfusion (V/Q) Mismatch
• Weaning. 
Conclusion
• Ventilatory support is a life-saving intervention for respiratory
failure.
• Understanding the physiology is crucial for effective patient
management.

The floor is open for your questions! 

Happy teacher’s day 
DEDICATED TO, SYED MUHAMMAD UMAIR.
You’re not just a teacher, you’re a mentor.
Thank you for guiding me.