Mechanical Ventilation

Definition:
When Patient fails to improvement in breathing by other measures, they should need oxygen therapy by Some respiratory support with mechanical ventilation, that improves the elimination of CO2.

Types of Mechanical Ventilation:
There are two types of mechanical ventilation;

• Non- Invasive mechanical ventilation.
• Invasive mechanical ventilation.

1- Non- Invasive mechanical ventilation:
In NIMV respiration is supported with face mask or nasal cannula and Endotracheal intubation avoided.
In this, Patient should be conscious, cooperative and be able to breath spontaneously and cough effectively by him or her self.
This Technique is commonly performed in COPD and Pneumonia.
2- Invasive mechanical ventilation:
In IMV Endotracheal tube is passed.
Patient may require;
* Full support and Partial support ventilator.
Full support Ventilator:
In this, all respiration controlled by ventilator.
In this case, Ventilator does not allow the spontaneous breathing.
Patient deeply sedative with short acting IV general anesthesia and paralyzed with muscles relaxant.
Partial support ventilator:
In this, all respiration does not controlled by ventilator, while patient also have his/her own effort.
It does not require deeply sedation or paralyses with muscles relaxant.

Indications:
Respiratory failure (Type II) that does not response to the medical treatment.
Head Injury- Patient have altered in mental status, and it controlled hyperventilation that reduce the Intra-cranial pressure.
Chest Injury- Flail chest, Pneumothorax and Hemothorax etc that reduces the breathing.
Severe Pulmonary edema.

Complications:
Tube insertion in one lung cause collapse of other lung.
Ventilator can induce the lung injury that leads to lungs infection.
It can cause Nosocomial, Hospital Acquired Pneumonia )HAP).
Abdominal Distention.
Fall in cardiac output (CO) due to positive pressure in lungs and thorax that reduce the venous return.