Mechanical Ventilation. Dr Aidah Abu Elsoud Alkaissi An-Najah National University Faculty of Nursing. Principles of Mechanical Ventilation.
Dr Aidah Abu Elsoud Alkaissi
An-Najah National University
Faculty of Nursing
Emerson iron lung exemplifying design dating back to the 1930s. Patient\'s head protrudes through neck collar on left, and electric motor beneath the tank generates negative pressure via the leather bellows on the right. The device weighs 300 kg.
medullary respiratory center: Is composed of several groups of neurons located bilaterally in the medulla oblongata and pons
Specialized nasal masks may be better tolerated. CPAP delivered through nasal masks (nasal CPAP) has become popular in patients with obstructive sleep-apnea.
A tension pneumothorax is a large pneumothorax with shifting of the mediastinal structures away from the side of the pneumothorax. Tension pneumothorax: Immediate correction can be accomplished with needle decompression. Place a 14-gauge angiocatheter into the 2nd intercostal space at the midclavicular line. This should convert a tension pneumothorax to a simple pneumothorax
of Tension Pneumothorax
■ Midline tracheal shift
■ Muffled heart tones
■ Absent breath sounds over affected lung
■ Hyperresonance الرنينto percussion over affected lung
■ Elevation in peak airway pressures in ventilated patients
■ Decrease in saturation of oxygen in arterial blood
(SaO2) or arterial oxygen tension (PaO2)
■ Cardiac arrest
Signas of pneumothorax include extreme dyspnea, hypoxia (indicated by a decrease in SaO2), and an abrupt increase in PIP.
The widespread use of antacids or histamine type 2 receptor (H2) blockersFamotidine, Cimetidine and Ranitidinecan predispose the patient to nosocomial infections because they decrease gastric acidity (increase alkalinity).
VAP is defined as nosocomial pneumonia in a patient who has been mechanically ventilated (by endotrachealtube or tracheostomy) for at least 48 hours at the time of diagnosis.
In addition, criticallyillpatients have an increased risk for colonization by the microorganisms contributed by poor oral hygiene.
In patients receiving enteral feedings, the head of the bed should be elevated 30 to 45 degrees (unless contraindicated) to decrease the risk of aspiration.
■ Atrophy of respiratory muscles
■ Decreased protein
■ Decreased albumin
■ Decreased cell-mediated immunity
■ Decreased surfactant production
■ Decreased replication of respiratory epithelium
■ Intracellular depletion of adenosine triphosphate (ATP)
■ Impaired cellular oxygenation
■ Central respiratory depression
ATP coenzyme used as an energy carrier ...