Ventiliation

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  • Ventilators
    • Features
      • SImple to use
      • portable
      • robust
      • easy to use and sterilise.HME filters
      • economical to purchase and use
      • versitile in supplying tidal volumes (merlin can provide this)
      • Variable I:E rations
      • able to deliver any gas/vapour mixture desired
      • have facility for humidification of gases and nebulisation of drugs and water
      • addition of PEEP should be possilbe.(Positive end expiratory pressure) this prevents alvelor collapse.  Has haemodynamic consequenses so not always used.
      • should have alarms for disconnection, high airway pressure and power failure
    • Classification
      • Method of cycling (how changes from inspiration to expiration)Volume or pressure
      • Expiratory cycling (how the ventilator changes from expiratory to inspiratory) most are timed cycled
      • method of operation (flow or pressure generated)
      • electrical or pneumatic
      • mechanical thumbs (basic types of ventilators)
      • bag in the bottle (has bellows in a perspex box - good one to use if first time)
      • minute volume dividers (portable)
      • intermittent blowers (sends a jet of gas down airway)
    • Settings
      • breathing rate 10-20bpm
      • Tidal volume (inspiratory) 10 - 15ml/kg10 - larger animals 15 - smaller animals
      • I:E ratio 1:3
      • Peak inspiratory pressure20cm H2O dogs12cm H2O cats
    • Complications
      • hypotension
        • increased
          • depth of anaesthesia
          • positive pressure in the chest
        • decreased
          • venous return to the heart
          • cardiac output
      • ventilator induced lung injury
        • Volutrauma
          • too much tidal volume
        • barotrauma
          • too much pressure
      • Untitled
      • Renal side effects
        • decreased cardiac output increases renin, angiotensin and aldosterone production
          • thus fluid retention tends to occur
            • tend to see reduced urine output
      • altering O2 and CO2 tensions
        • overzelous IPPV
          • hypocapnia
        • inefficient IPPV
          • produce hypercapnia
        • O2 toxicity in ICU ventilation

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