Basics of mechanical ventilation
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basics for mechanical ventilator
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Basics of mechanical ventilation
- 3. Lung Function Prime function exchange of O2 and CO2 Other functions, a. blood reservoir b. heat exchange c. metabolism - synthesis & catabolism d. immunological and mechanical defence
- 4. BASICS
- 5. AIRWAYS Main Airway Branches & Zones Conducting zone ( generations 1-16 ) Trachea R+L main bronchi Lobar bronchi Segmental bronchi Bronchioles Terminal bronchioles Respiratory zone ( generations 17-23) Respiratory bronchioles Alveolar ducts Atria Alveolar sacs
- 8. Dead space Anatomical dead space CZ doesn't contribute to gas exchange - Physiological dead space It is the combination of anatomical dead space and alveolar dead space.
- 9. Cell Types in the Respiratory Tract 1. Alveolar type I cells – Ventilation 2. Alveolar type II cells - produce surfactant 3. Alveolar type III cells ? function = "brush" cells 4. Capillary endothelium 5. Alveolar macrophages 6. Mast Cells 7. Non-ciliated bronchial epithelial, "Clara", cells 8. APUD cells
- 10. Surfactant Reduce surface tension
- 11. Perfusion How many capillaries for each alveoli ?? For gas exchange – alveoli must contact with ample blood supply 1 million alveoli : 280 billion capillaries
- 13. Diaghram contracts ↑Chest volume ↓Pleural pressure Air moves down pressure gradient to fill lungs -2cm H20 -7cm H20 Alveolar pressure falls Lung @ FRC= balance Normal inspiration
- 14. Diaghram relaxes Pleural / Chest volume ↓ Pleural pressure rises Alveolar pressure rises Air moves down pressure gradient out of lungs -7cm H20 -2cm H20 Normal expiration
- 15. Air blown in ↑ lung pressure Air moves down pressure gradient to fill lungs ↑ Pleural pressure 0 cm H20 +5 to+10 cm H20 Ventilator inspiration
- 16. Ventilator expiration Ventilator stops blowing air in Pressure gradient Alveolus-trachea Air moves out Down gradient ↓ Lung volume
- 18. LUNG VOLUMES primary lung volumes i. RV Residual Volume ii. ERV Expiratory Reserve Volume iii. TV Tidal Volume iv. IRV Inspiratory Reserve Volume
- 19. secondary derived capacities i. TLC Total Lung Capacity ii. VC Vital Capacity iii. IC Inspiratory Capacity iv. FRC Functional Residual Capacity
- 21. Tidal volume Dead space Alveolar ventilation minus =
- 22. Alveolar ventilation Volume of fresh gas entering the alveoli per breath VA = VT - VD
- 23. Minute volume = VT × respiratory rate
- 24. Alveolar minute ventilation Alveolar ventilation x respiratory rate
- 25. Gas exchange and transport
- 27. Carbon Dioxide (CO2) Elimination Depends on alveolar minute ventilation
- 29. Oxygenation
- 30. COMPLIANCE Compliance describes the elasticity or distensibility compliance = volume / pressure
- 31. Normal ventilating lungs Normal Compliance
- 35. RESISTANCE inherent capacity to oppose airflow and expressed as the change in pressure per unit change in flow: Resistance = pressure/ flow
- 36. Airway resistance depends on 1) radii of the airways (total cross- sectional area), 2) length of airways, 3) flow rate, 4) density and viscosity of gas breathed.
- 37. Time constant
- 38. Time constant time necessary for the alveolar pressure to reach 63% of the change in airway pressure Time constant = resistance x compliance
- 40. This is not the end, It’s just the beginning….
- 41. THANK YOU