Intensive Care Medicine/organ/ventilation

Introduction

Mechanical ventilation is a form of organ supportive therapy which employs breathing assist devices in circumstances when the patient's breathing apparatus is unable to provide sufficient vital gas exchange. Such devices range from simple human-powered "Bag-Valve-Mask" Ventilators to electricity-powered, compressor-driven, computerized Ventilators. A simple overview is provided in Fig 1.

Fig 1. Overview of Mechanical Ventilators

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(Work in progress) - Basic physics -- Composition of the Atmosphere -- Pressures and Partial Pressures - Breathing -- Lung volumes -- Breathing mechanics ---Resistance/Elastance/Compliance --- Work of breathing -- Control of Breathing - The Oxygen transport system -- Haemodynamic influences -- Haemoglobin, Red Blood Corpuscles and dissolved Oxygen -- Intracellular Oxygen transport - Mitochondrial Respiration - Carbon-di-Oxide origin and transport

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(Work in progress)

Schematic diagram of electro-mechanical ventilator

- Design of Mechanical Ventilators -- The Bag-Valve-Mask system -- Electro-Mechanical ventilators --- Normal Frequency ventilators --- High Frequency Oscillatory ventilators -- Control systems -- Software 'Modes' of ventilation --- Assistive ventilatory modes

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Invasive

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Feed-back modes

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Non-invasive

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Feed-back modes

--- Replacement ventilatory modes -- Understanding various parameters - Patient ventilator matching - Assessment of efficacy of ventilation

Liberation from the ventilator

(Work in progress)

Complications relating to Mechanical Ventilation and prevention strategies

(Work in progress) - Ventilator Induced Lung Injury - Ventilator-associated Pneumonia

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