A Ventilator is an important medical instrument for artificial ventilation of patients. It will also respirator called.
What is a ventilator?
A ventilator is understood to be a technical device that is used to ventilate people. In medicine, the device is also called the respirator. The instrument is driven either pneumatically or by the control of microprocessors. It is used to treat patients whose breathing is inadequate or has even stopped breathing.
A ventilator creates overpressure inside the pharynx (nasopharynx) through a tracheostomy tube. This allows the lungs to receive incoming air. The exhalation of air is done by the retraction forces of the lungs.
To ensure that the ventilation function runs safely, the ventilator takes on both the inhalation process (inspiration), the exhalation process (expiration) and the change between the two processes.
Shapes, types & types
Depending on the area in which a ventilator is used, a distinction must be made between different types. There are emergency ventilators, intensive care ventilators, home ventilators and tank ventilators.
Emergency respirators are also known as transport respirators. They are primarily used by emergency services and in intensive care medicine to transport patients to an operation. For this reason, the emergency respirators are robustly equipped. Important parameters such as the breathing time ratio or the oxygen concentration can be set on some transport ventilators. They guarantee short-term ventilation, which is usually volume-controlled.
Intensive respirators are ventilators that are used for longer breathing treatments. They are used under intensive medical conditions and guarantee all types of ventilation. An intensive ventilator is equipped with various alarm, measurement and documentation options. In addition, the devices can be better adapted to the patient and his illness. Connection to a network is also possible.
Home respirators are ventilators that are used within the patient's own four walls. In this case, there is reduced natural breathing due to disorders of the respiratory muscles or the nervous system. Nevertheless, the patient can leave the hospital and continue ventilation at home. Home ventilators are smaller in structure than other forms, which allows them to be installed in the patient's home without difficulty. In addition, home ventilators are easy to use and transport.
One of the early ventilators was the iron lung, which is counted among the tank respirators. The patient lies up to his neck in the iron lung, which encloses him airtight. Ventilation takes place through the creation of negative pressure inside the chamber.
Structure & functionality
A ventilator is composed of various components. These include a patient system that includes breathing tubes, valves and humidifiers, an electronically driven control and drive system, and a gas mixing device to mix and supply breathing gas.Another important component is an operating and monitoring unit.
A respirator is basically controlled by flow or pressure generators. In the case of a flow, a mixture of breathing gas reaches the lungs at a flow rate that is previously determined. The preset volume can be reproduced even if the lung resistance changes. With this procedure it is possible to ventilate the tidal volume variably past the lungs.
If a pressure generator is used, a fixed pressure is used to enable insufflation of the breathing gas. The volume insufflated decreases as the airway pressure increases during inhalation. If there is an acute increase in breathing resistance, this results in a decrease in the insufflated volume. If there is a leak in the ventilation system, such as an inadequate tube blockage, the ventilator will still attempt to reach the previously set pressure, which results in better ventilation.
The ventilator has the ability to control ventilation based on time, volume, or pressure. In this way, maximum values can be determined for inspiration. If this value is reached, the transition to expiration begins. With volume control, inspiration continues until a defined inspiration volume is reached. In the case of a time-controlled respirator, the device carries out inspiration according to a schedule that is set in advance.
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The use of ventilators is an indispensable part of modern medicine. The vital instruments are used to support or replace the patient's spontaneous breathing. They are primarily used in intensive care and emergency medicine as well as in anesthesiology.
The first attempts at artificial ventilation were made in ancient times. From 1763, flexible metal tubes were used for intubation. With the help of bellows, the doctors filled the lungs with air. The iron lung was first used in 1876, supplying patients with oxygen by generating negative pressure. It is considered the beginning of the actual ventilation therapy.
Ventilators are used when the patient cannot breathe safely and cannot be supplied with oxygen. This can u. a. be the case during a coma or after cardiac arrest. Other possible areas of application are COPD (chronic obstructive pulmonary disease), brain damage, neuromuscular diseases that are associated with disorders of the respiratory function, and deformations of the chest. A respirator can also be of great use to those who are seriously overweight.
Ventilators also play an important role in performing extensive surgical procedures. During general anesthesia, for example, the patient's respiratory function is reduced, so that a mechanical supply of oxygen is required at times. Respirators are also often used in intensive care units.
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