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Respiratory Care Aug 2011The use of ventilatory assistance can be traced back to biblical times. However, mechanical ventilators, in the form of negative-pressure ventilation, first appeared in...
The use of ventilatory assistance can be traced back to biblical times. However, mechanical ventilators, in the form of negative-pressure ventilation, first appeared in the early 1800s. Positive-pressure devices started to become available around 1900 and today's typical intensive care unit (ICU) ventilator did not begin to be developed until the 1940s. From the original 1940s ventilators until today, 4 distinct generations of ICU ventilators have existed, each with features different from that of the previous generation. All of the advancements in ICU ventilator design over these generations provide the basis for speculation on the future. ICU ventilators of the future will be able to integrate electronically with other bedside technology; they will be able to effectively ventilate all patients in all settings, invasively and noninvasively; ventilator management protocols will be incorporated into the basic operation of the ventilator; organized information will be presented instead of rows of unrelated data; alarm systems will be smart; closed-loop control will be present on most aspects of ventilatory support; and decision support will be available. The key term that will be used to identify these future ventilators will be smart!
Topics: Equipment Design; History, 18th Century; History, 19th Century; History, 20th Century; History, 21st Century; Humans; Respiration, Artificial; Ventilators, Mechanical
PubMed: 21801579
DOI: 10.4187/respcare.01420 -
Respiratory Care Nov 2014The American Association for Respiratory Care has declared a benchmark for competency in mechanical ventilation that includes the ability to "apply to practice all... (Review)
Review
The American Association for Respiratory Care has declared a benchmark for competency in mechanical ventilation that includes the ability to "apply to practice all ventilation modes currently available on all invasive and noninvasive mechanical ventilators." This level of competency presupposes the ability to identify, classify, compare, and contrast all modes of ventilation. Unfortunately, current educational paradigms do not supply the tools to achieve such goals. To fill this gap, we expand and refine a previously described taxonomy for classifying modes of ventilation and explain how it can be understood in terms of 10 fundamental constructs of ventilator technology: (1) defining a breath, (2) defining an assisted breath, (3) specifying the means of assisting breaths based on control variables specified by the equation of motion, (4) classifying breaths in terms of how inspiration is started and stopped, (5) identifying ventilator-initiated versus patient-initiated start and stop events, (6) defining spontaneous and mandatory breaths, (7) defining breath sequences (8), combining control variables and breath sequences into ventilatory patterns, (9) describing targeting schemes, and (10) constructing a formal taxonomy for modes of ventilation composed of control variable, breath sequence, and targeting schemes. Having established the theoretical basis of the taxonomy, we demonstrate a step-by-step procedure to classify any mode on any mechanical ventilator.
Topics: Humans; Respiration, Artificial; Ventilators, Mechanical
PubMed: 25118309
DOI: 10.4187/respcare.03057 -
Gaceta Medica de Mexico 2021
Topics: Humans; Respiration, Artificial; Ventilators, Mechanical
PubMed: 34270537
DOI: 10.24875/GMM.20000572 -
Respiratory Care Jan 2022Mechanical ventilators display detailed waveforms which contain a wealth of clinically relevant information. Although much has been written about interpretation of...
Mechanical ventilators display detailed waveforms which contain a wealth of clinically relevant information. Although much has been written about interpretation of waveforms and patient-ventilator interactions, variability remains on the nomenclature (multiple and ambiguous terms) and waveform interpretation. There are multiple reasons for this variability (legacy terms, language, multiple definitions). In addition, there is no widely accepted systematic method to read ventilator waveforms. We propose a standardized nomenclature and taxonomy along with a method to interpret mechanical ventilator displayed waveforms.
Topics: Humans; Respiration, Artificial; Ventilators, Mechanical; Patients
PubMed: 34470804
DOI: 10.4187/respcare.09316 -
Kyobu Geka. the Japanese Journal of... Jul 2009The development of the computer technology brought reform in the field of medical equipment. Originally the mechanical ventilator was an instrument only as for running... (Review)
Review
The development of the computer technology brought reform in the field of medical equipment. Originally the mechanical ventilator was an instrument only as for running by pressure and the tool that let you breathe. However, it has a function to assist a measurement (tidal volume, peek pressure, etc.) and to wean from a ventilator. There is a case to use a mechanical ventilator for after a chest surgical operation. After the operation without the complication, it seems that there is not the special administration. However, special respiratory management is necessary in case of chronic respiratory failure and acute lung injury, acute respiratory distress syndrome. Therefore I introduce a method to use a respirator after an operation in our institution.
Topics: Equipment Design; Humans; Ventilators, Mechanical
PubMed: 20715681
DOI: No ID Found -
Journal of Intensive Care Medicine May 2023The increased application of mechanical ventilation, the recognition of its harms and the interest in individualization raised the need for an effective monitoring. An... (Meta-Analysis)
Meta-Analysis Review
The increased application of mechanical ventilation, the recognition of its harms and the interest in individualization raised the need for an effective monitoring. An increasing number of monitoring tools and modalities were introduced over the past 2 decades with growing insight into asynchrony, lung and chest wall mechanics, respiratory effort and drive. They should be used in a complementary rather than a standalone way. A sound strategy can guide a reduction in adverse effects like ventilator-induced lung injury, ventilator-induced diaphragm dysfunction, patient-ventilator asynchrony and helps early weaning from the ventilator. However, the diversity, complexity, lack of expertise, and associated cost make formulating the appropriate monitoring strategy a challenge for clinicians. Most often, a big amount of data is fed to the clinicians making interpretation difficult. Therefore, it is fundamental for intensivists to be aware of the principle, advantages, and limits of each tool. This analytic review includes a simplified narrative of the commonly used basic and advanced respiratory monitors along with their limits and future prospective.
Topics: Humans; Respiration, Artificial; Ventilators, Mechanical; Ventilator-Induced Lung Injury; Lung; Monitoring, Physiologic; Respiratory Mechanics
PubMed: 36734248
DOI: 10.1177/08850666231153371 -
Partitioning Mechanical Ventilator Duration in COVID-19-related Acute Respiratory Distress Syndrome.American Journal of Respiratory and... Jul 2022
Topics: COVID-19; Humans; Respiration, Artificial; Respiratory Distress Syndrome; Ventilator Weaning; Ventilators, Mechanical
PubMed: 35394404
DOI: 10.1164/rccm.202108-1963LE -
The Pan African Medical Journal 2022Respiratory care for the critically ill is a complex and difficult duty to accomplish. By replicating human knowledge with automated algorithms, artificial intelligence...
Respiratory care for the critically ill is a complex and difficult duty to accomplish. By replicating human knowledge with automated algorithms, artificial intelligence could provide solutions to facilitate this multidisciplinary task in developing countries, especially during humanitarian crisis, as the COVID-19 pandemic. This article provides an overview on the subject, from the emergent nations perspective.
Topics: Artificial Intelligence; COVID-19; Critical Illness; Humans; Pandemics; Respiration, Artificial; Ventilators, Mechanical
PubMed: 35865861
DOI: 10.11604/pamj.2022.41.321.29726 -
Laboratory Animals Dec 2020For investigating the effects of mechanical ventilation on the respiratory system, experiments in small mammal models are used. However, conventional ventilators for...
For investigating the effects of mechanical ventilation on the respiratory system, experiments in small mammal models are used. However, conventional ventilators for small animals are usually limited to a specific ventilation mode, and in particular to passive expiration. Here, we present a computer-controlled research ventilator for small animals which provides conventional mechanical ventilation as well as new type ventilation profiles. Typical profiles of conventional mechanical ventilation, as well as flow-controlled expiration and sinusoidal ventilation profiles can be generated with our new ventilator. Flow control during expiration reduced the expiratory peak flow rate by 73% and increased the mean airway pressure by up to 1 mbar compared with conventional ventilation without increasing peak pressure and end-expiratory pressure. Our new ventilator for small animals allows for the application of various ventilation profiles. We could analyse the effects of applying conventional ventilation profiles, pressure-controlled ventilation and volume-controlled ventilation, as well as the novel flow-controlled ventilation profile. This new approach enables studying the mechanical properties of the respiratory system with an increased freedom for choosing independent ventilation parameters.
Topics: Animals; Female; Positive-Pressure Respiration; Rats; Rats, Wistar; Respiration, Artificial; Ventilators, Mechanical
PubMed: 32075500
DOI: 10.1177/0023677220906857 -
Current Opinion in Critical Care Feb 2005To provide some practical and clinical considerations that may guide users through the decision process when choosing mechanical ventilators (Review)
Review
PURPOSE OF REVIEW
To provide some practical and clinical considerations that may guide users through the decision process when choosing mechanical ventilators
RECENT FINDINGS
Although the complexity of mechanical ventilators is steadily increasing, the importance of many devices developed over the course of the technical evolution is still a matter of discussion. Recent data demonstrate that the technical performance of equivalent ventilators (ie, machines of the same generation and category) is pretty similar, suggesting that the different manufacturers keep in step with new developments. Thus, other factors than technical limitations will probably influence the choice of ventilators. Among them the ability of the staff to understand the rationale of the different devices and controls as well as deal with the complexity of the ventilator may be particularly important.
SUMMARY
Choosing mechanical ventilators should begin by defining the algorithms of how to ventilate a patient. Once this is done, a ventilator should allow the transformation of specific strategies into practice and the adaptation of the mechanical support to the needs of the individual patient. This procedure is crucially important, because ventilator therapy should always be determined by the physician and based on solid physiologic rationales rather than by the technical features of the machine.
Topics: Artificial Intelligence; Equipment Design; Humans; Intubation, Intratracheal; Monitoring, Physiologic; Positive-Pressure Respiration; Respiration, Artificial; Respiratory Mechanics; Ventilators, Mechanical
PubMed: 15659945
DOI: 10.1097/00075198-200502000-00008