Anatomy of a ventilator! (PART I)


Anatomy of a ventilator! (PART I)

Brief Physiological notion
Let’s talk about ventilators! Hey guys! We are talking about “ventilators” to meet the respiratory function, not for us to “fan” the head and give us a sense of cool ambient air! (Conditioned ventilators! lol)

A important difference is what is routinely called “respirator” to a “ventilator”.

Many people, including doctors inaccurately using the word “respirator”. It is true that it is a commonly used word, but very badly used! The act of breathing is also misused. Respiration is a metabolic process of cells and we breathe the oxygen through the blood mixed with the oxygen receptor cells are mitochondria (the real respiratory systems). It is what is known as aerobic metabolism (with oxygen).

So what do we do?, It is very simple … we do is an act of introducing air into the lungs and that is called “venting.” The movement of gas from outside to inside the lungs is called ventilation. This act comes into contact ambient air (of which 21% is oxygen) enters through the mouth into the trachea and then the following tubes called bronchi (right and left) that act as a tube that moves air, coming to rest of the bronchi and then into the bronchioles that are thinner and thus progressively until the last portions called terminal bronchioles where the alveoli begin to develop (such as sponges) which is the location of the lungs in touch the blood through capillaries in contact with them.
The alveoli are the smallest portion of the lung and the most important because it will condition the gas exchange (oxygen or O2 over the blood and removing carbon dioxide or CO2 exhaled air).

It is true that in the end it comes to respiratory failure, because the definition is purely after hearing the results of blood gas analysis (drop in oxygen to the critical level of less than 60 mmHg and ventilation when exceeding the barrier the 50 mmHg) as we said before.
When this happens, depending on the situation according to our actions will address the two mechanisms.
In the earlier case of choking (or asphyxia box) rather than to oxygen (which is worthless) ventilation needs to be fixed because the fundamental problem is that no air. For that first perform a Heimlich maneuver, or if not possible, try to remove the object blocking the airway (in this case the glottis) with fingers in the mouth when the patient is in apnea (otherwise you could bite the fingers) or a tracheostomy in place of the accident (for suitable equipment).
Once you open the airway if the patient moves even try to get the chest to air (air) oxygen will (always in an amount greater than the ambient air being restated is 21%).

There are many causes of respiratory failure and respiratory finally (and this site is not the place to explain) but if it is serious enough that the patient may lose his life and the oxygen is not remedied, the patient should help gold intubation -trachea (the trachea from the mouth).
Important notice for people:
The following pics is of our production (intubation) and pray that those who have qualms to see real images, to refrain from him.
Thank you!

We introduce the laryngoscope blade through the mouth, displacing the side of the tongue from right to left to let us see the mouth cavity.

Time of displacement of the tongue

Once displaced tongue can observe the pharynx and the folds of the tonsils

The direct vision of the epiglottis (where the vocal cords and trachea at the bottom) leads us to introduce the ETT (endotracheal tube) and save the patient’s life.

The epiglottis is a cartilaginous structure that is part of the cartilaginous skeleton of the larynx. It also marks the boundary between the oropharynx and laryngopharynx.

The glottis is the narrowest portion of the light laryngeal space is limited by the vocal cords, arytenoid vocal portion and the area interarytenoid.

Introduction of the tracheal tube is made through the center hole or glottis.

Endotracheal tube position.

Final placement of the tracheal tube and the patient is intubated

Well … we’ve reached the point where once intubated the patient is connected to a life support machine called “mechanical ventilation” or poorly named “artificial respirator”

CLICK HERE FOR THE NEXT POST!

Herrero S. “Anatomy of a ventilator! (Part I)”  Journal of Pearls in Intensive Care Medicine 2011. Volumen 1. Nº 15

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Herrero-Varon's MD Editors. Asturias (Gijón) and Houston (TX, USA). Languaje EN/ES 2011-2016