Innovative Approaches: High-Flow Oxygen Therapy in the ICU

Innovative Approaches: High-Flow Oxygen Therapy in the ICU

by with No Comment Uncategorized

Intensive Care Unit (ICU) is different, whereby individuals suffering from acute and critical respiratory conditions demand complex assistance. Mechanical ventilation has proved crucial for the medical care of these cases for decades. Mechanical ventilators are frequently used in pathological situations such as low oxygen levels or high carbon dioxide levels where the patient has difficulty breathing. Nevertheless, over recent years, there appears to be a new therapeutic way called high-flow oxygen therapy, which is likely to substitute or serve with traditional respiration practices. The goal is to create a particular focus on optimizing humidification to enhance patient comfort and respiratory support. 

High-Flow Oxygenation (HFO)

In clinical applications, oxygen therapy can be given as low flow (with mask or nasal cannula) or high flow (Venturi mask or nonrebreathers). However, in conventional methods, some of the oxygen inhaled by the patient is not delivered completely. Since the oxygen is not heated and humidified, the patient may not tolerate it for long periods. High-flow oxygen therapy, which is mainly used for respiratory diseases in pediatric patients, has found a serious place, especially in the COVID-19 pandemic and has begun to be widely used in adult patients as well.  

High-flow oxygen/cannula therapy is gaining widespread attention as an alternative approach to respiratory support in intensive care patients. This method is applied via air or oxygen mixer (rate up to 60 L/min at 21% to 100% oxygen fraction), humidifier, patient circuit and nasal cannula. The high-flow, warmed, humidified oxygen removes carbon dioxide from the anatomical dead space, making breathing easier and increasing patient comfort.

Benefits of HFO in ICU

The benefits of HFO go further than simple improvement in gas exchange. Compared to traditional mechanical ventilation, HFO offers numerous advantages:

  • Comfortable for patients: The nasal prongs are soft and small. Several studies stated that patient comfort is higher with HFNC than with a conventional nasal cannula or face mask
  • Warming and humidification of secretions: There is no chance for warming and heating oxygen when applying with a nasal cannula or face mask. In HFNC, oxygen is humidified and warmed before being administered to the patient. This increases the patient’s ability to tolerate treatment over a long period. This can facilitate the removal of mucus and other secretions from the airway. 
  • PEEP effect: Although the HFNC is an open system, the high-flow nasal cannula provides resistance to expiratory flow and increases airway pressure. PEEP decreases lung compliance, residual capacity reduction and elimination of refractory hypoxia. PEEP allows collapsed lung alveoli to open. It improves oxygenation and lung compliance.
  • High flow rate: Access to 60 L/min oxygen flow, which is not possible with normal oxygen devices, is possible with HFNO devices. Flow rate, humidity and temperature can be adjusted with the device. This allows the treatment to be adapted to the individual’s condition, increasing effectiveness.

Mechanism Of Action And Clinical Applications

Nasal high-flow therapy contributes to improving the fractionation of alveolar gases by reducing nasopharyngeal dead space. The expandability of the nasopharynx provides significant inspiratory resistance relative to expiratory effort.

HFNO provides adequate flow rates to accommodate inspiratory flow and thus significantly reduces the inspiratory resistance associated with the nasopharynx and thus eliminates the associated work of breathing. Delivery of heated and humidified oxygen to the respiratory organs increases pulmonary compliance and reduces metabolic load compared to dry and cold gas. The high flow in the nasopharynx provides positive tensile pressure to activate the lungs.

High flow oxygen therapy indicates for hypercapnic respiratory failure, hypoxemic respiratory failure, post-extubation, preintubation oxygenation, acute heart failure and sleep apnea. In pediatric patients, it is mainly indicated for bronchiolitis, but also for pneumonia, croup, asthma and post-extubation.

Patient-Centered Care and Comfort

Patient comfort and satisfaction in the rigorous conditions of the ICU are critical aspects of providing quality health care. From the patient’s perspective, HFO significantly reduces discomfort associated with traditional mechanical ventilation.

  • Reduced Discomfort: A soft nasal cannula and gentle airflow take away distress caused by the endotracheal tube, making patients more tolerant and less anxious.
  • Improved Communication: Additionally, the methodology enables patients to communicate freely with each other during their stay, which facilitates an improved atmosphere.
  • Enhanced Sleep Quality: Compared to mechanical ventilation, HFO allows for better rest and, consequently, better recovery of patients because it is less noisy and does not cause disruption.

Clinical Outcomes and Cost-Effectiveness

HFO therapy has been studied extensively and proven clinically beneficial. One of the most comprehensive studies investigating the effectiveness of nasal high-flow therapy is the Clinical Guideline published by the American College of Physicians. According to this guideline, compared to NIV, it has been shown to improve clinical outcomes as an initial treatment for acute respiratory failure and improve patient comfort by reducing re-intubation compared to standard oxygen therapy. It is stated that it causes fewer complications in patients than NIV or COT.

The effectiveness of HFNO in patients with hypoxia in acute heart failure was investigated in a retrospective cohort study. It has been stated that there is a better improvement in left ventricular parameters in patients receiving HFNO treatment compared to non-invasive positive pressure ventilation. It has been concluded that HFNO may be an ideal model, especially in hypoxemic AHF patients.

In another meta-analysis investigating the use of HFNO in anesthesia induction, it was compared with FMV. The use of HFNo for anesthesia induction has been shown to significantly improve oxygenation compared to FMV.

In addition to those mentioned above, many scientific studies are showing the effectiveness of HFNO.

Cost Savings

In a study conducted in England, the cost-effectiveness of HFNO use was investigated. Three different cost-effectiveness models were used in this study: the pre-intubation model and the post-extubation model in low-risk and high-risk patients. The use of HFNO in first-line treatment is reported to provide estimated savings of £469 per patient compared to standard oxygen therapy and £611 compared to NIV. NHF cost savings for the high severity subgroup were found to be £727 compared to standard oxygen and £1,011 compared to NIV.

For post-intubation low-risk patients, NHF provides an estimated cost saving of £156 compared to standard oxygen. The savings for post-intubation high-risk patients was stated to be £104.

Another study in infants with bronchiolitis compared low-flow oxygen therapy and HFNO therapy. In this study, treatment costs were found to be between $1786-3600 for HFNO, while these figures were found to be between $2175-5125 for standard treatment. Based on this, the cost-effectiveness of high-flow oxygen therapy can be demonstrated.

high-flow oxygen device

Introducing Bio2Flow: Your Partner in High-Flow Oxygen Therapy The Right Way

Giving a significant gain to the medical device world with Biyovent, an Intensive Care type mechanical ventilation device, Biosys continues to produce new device solutions for the sector. BiO2Flow, a high-flow oxygen therapy device, is a revolutionary device.

If you would like to get detailed information about this revolutionary device, you can browse our catalogue and get the details from the link. For our other products, follow the link.

References

  • Walter K. Mechanical Ventilation. JAMA. 2021;326(14):1452. doi:10.1001/jama.2021.13084
  • Heated and humidified high-flow nasal oxygen in adults: Practical considerations and potential applications, Robert C Hyzy, MD, Uptodate, Access time: Dec 2023
  • Huiying Gao, Lin Chen, Xiaofei Kang, High-Flow Nasal Cannula Oxygen Therapy in Patients With Acute Heart Failure: A Meta-analysis, The Journal for Nurse Practitioners, Volume 19, Issue 5,2023, https://doi.org/10.1016/j.nurpra.2023.104602.
  • Nishimura M. High-Flow Nasal Cannula Oxygen Therapy in Adults: Physiological Benefits, Indication, Clinical Benefits, and Adverse Effects. Respir Care. 2016 Apr;61(4):529-41. doi: 10.4187/respcare.04577. PMID: 27016353.
  • Toffaletti JG, Rackley CR. Monitoring oxygen status. Adv Clin Chem 2016;77:103-24.
  • Emily Eaton Turner &Michelle Jenks (2017), Cost-effectiveness analysis of the use of high-flow oxygen through nasal cannula in intensive care units in NHS England, https://doi.org/10.1080/14737167.2018.1411804
  • Paula Heikkilä MSc, Leena Forma PhD, Matti Korppi MD, PhD (2016), High-flow oxygen therapy is more cost-effective for bronchiolitis than standard treatment—A decision-tree analysis, Pediatric Pulmonology, https://doi.org/10.1002/ppul.23467
  • Kevin Dysart, Thomas L. Miller, Marla R. Wolfson, Thomas H. Shaffer, Research in high flow therapy: Mechanisms of action, Respiratory Medicine, Volume 103, Issue 10,
  • 2009,Pages 1400-1405, https://doi.org/10.1016/j.rmed.2009.04.007.
  • Baldomero, A. K., Melzer, A. C., Greer, N., Majeski, B. N., MacDonald, R., Linskens, E. J., & Wilt, T. J. (2021). Effectiveness and Harms of High-Flow Nasal Oxygen (HFNO) for Acute Respiratory Failure: An Evidence Report for a Clinical Guideline by the American College of Physicians. Annals of Internal Medicine, 174(7), 952. https://doi.org/10.7326/M20-4675
  • Song, Jl., Sun, Y., Shi, Yb. et al. Comparison of the effectiveness of high-flow nasal oxygen vs. standard facemask oxygenation for pre- and apneic oxygenation during anesthesia induction: a systematic review and meta-analysis. BMC Anesthesiol 22, 100 (2022). https://doi.org/10.1186/s12871-022-01615-7
  • Tong, Xiao MDb; Tong, Ningning MDa; Yao, Feifei MDc; Yan, Jing MDd; Ci, Caizhe MDd,*. Clinical outcomes of high-flow nasal cannula oxygen therapy in acute heart failure patients with hypoxemia: A retrospective cohort study. Medicine 101(43):p e31124, October 28, 2022. | DOI: 10.1097/MD.0000000000031124
what-are-the-4-different-types-of-medical-ventilators

What are the 4 Different Types of Medical Ventilators?

by with No Comment Uncategorized

Currently, there are different types of ventilators offered to patients by health units in accordance with the patient’s needs. Depending on the particular circumstances, ventilators can be typed according to where the treatment needed by the patient has been applied and how it is applied; these types are as follows: ICU ventilators, Home ventilators, Ambulatory and Emergency ventilators, and Anaesthesia ventilators. This article covers various types of medical ventilators.

ICU Ventilators

Generally named after where they are mainly used, ICU ventilators are typically the most advanced and critical care ventilators. They are used in ICU settings in hospitals and health facilities, for the most serious patients and with the most severe respiratory conditions.

These sophisticated machines offer many modes differing to condition and illness: volume assist/control (v- A/C), pressure assist/control (p- A/C), pressure support ventilation (PSV), synchronized intermittent mandatory ventilation with volume support (vSIMV) and synchronized intermittent mandatory ventilation with pressure support (p-SIMV. (1) 

With one variable, only ventilation can be applied. Still, ICU ventilators have dual control (of both volume and pressure). An ICU ventilator uses both variables, volume, and pressure, to present ideal breath to patients. 

In addition, to the expected need for wide monitorization and control mechanisms in ICU patients, an ICU ventilator has wide settings menu, interface, and dedicated keys that are more complex than other ventilator types. (1) ICU ventilators present FiO2 sensors and large displays, particularly for breath rate, Peep Inspiratory Pressure, and exhaled tidal volume monitorization. They also have more complex and better secure locks and alarm systems. 

Home Ventilators 

The name can easily understand as home ventilators or home care ventilators; they are mechanical ventilators designed to serve the patient’s needs at home or in other places like palliative support facilities. (2) These ventilators should be simple because they can be used by people who are not trained as much as a health care practitioner or a clinician. Also, these ventilators should be complex simultaneously because they have some features of highly sophisticated ventilators; for a better-using home, ventilators have a non-complex interface, an easily operatable system, and minimal accessories. They are the most fitted ventilators for a patient’s breathing needs at home with a short trigger time. (3) And they are also tough machines with low costs. Patients with respiratory failure, chronic obstructive pulmonary disease (COPD) (4), amyotrophic lateral sclerosis (ALS), restrictive lung disease, congenital muscular dystrophies, etc., can be put on home ventilator care.

Ambulatory and Emergency Ventilators 

These are breathing devices deployed at short notice for patients in emergency or/and when they need to be transferred from one place to another to their medical condition. These are self-contained, compact, and sturdy ventilators for the most challenging weather and other circumstances. In some cases, Ambulatory and Emergency ventilators can use them for the post-operative care of patients. These ventilators feature technological developments that are as close as possible to modern ICU ventilators.

Anesthesia Ventilators 

These ventilators are typically employed in surgery room settings for patients who are undergoing a surgical operation and/or to help them to breathe during the post-op period to recovery. (5) They are more limited than ICU ventilators in the range of ventilatory settings and monitoring features. Again, anesthesia ventilators allow most, but not all, features present in an ICU ventilator. Typically, they have volume-controlled (VCV) and pressure-controlled (PCV) modes. However, besides the conventional types, modern anesthesia ventilators today present newer modes of ventilation such as synchronized intermittent mandatory ventilation (SIMV) and pressure support ventilation (PSV). (6)

Therefore, these are different types of ventilators offered to patients by health units in accordance with the patient’s needs. Depending on the particular circumstances, ventilators can be typed according to where or how it is applied. However, it is essential to remember that most of these ventilators have certain superimposed features. Obviously, on facing any respiratory problem that is mild or severe, the user or applier should seek advice from experts about which type of ventilator is appropriate to use. Indeed, experts’ recommendations should be followed.

Discover the ultimate choice in smartwatch bandjes and horlogebandjes at our online store! Elevate your style with our premium selection of horlogebandjes designed to complement your smartwatch perfectly. Upgrade your look effortlessly with our range of horlogebandjes for every occasion.

Type of Ventilators

Let’s Meet with Biyovent ICU Types of Mechanical Ventilator

Biyovent ICU Ventilator makes a difference in the ventilation process with its unique specifications. Biyovent has been carefully thought out with every detail of the ventilators and developed with a holistic approach. Prepared for mass production in cooperation with Arçelik, Baykar, and Aselsan.

What are some specific features of Biyovent?

  • Invasive and Non-invasive Ventilation
  • Integrated Nebulizer
  • High Flow Oxygen Therapy
  • Suitable for Pediatric, Adult and Newborn (Optional) Patients
  • Smart Ventilation Modes

Learn more details about Biyovent ICU Ventilator

Get in contact with Biosys Sales Team

References

1 – Chatburn, R. L., El-Khatib, M., & MirelesCabodevila, E. (2014). A taxonomy for mechanical ventilation: 10 fundamental maxims. Respiratory care, 59(11), 1747–1763. https:// doi.org/10.4187/respcare.03057

2 – Simonds A. K. (2006). Risk management of the home ventilator-dependent patient. Thorax, 61(5), 369–371. https://doi.org/10.1136/ thx.2005.055566

3 – Grassion, L., Llontop, C., Layachi, L., Hubert, E., Morelot-Panzini, C., & Gonzalez-Bermejo, J. (2018). Définitions des paramètres de ventilateurs de domicile [Home care ventilator’s settings]. Revue des maladies respiratoires, 35(9), 992–996. https:// doi.org/10.1016/j.rmr.2017.04.004

4 – Ambrosino N, Vagheggini G. Non-invasive ventilation in exacerbations of COPD. Int J Chron Obstruct Pulmon Dis. 2007;2(4):471-476.   

5 – Coisel, Y., Millot, A., Carr, J., Castagnoli, A., Pouzeratte, Y., Verzilli, D., Futier, E., & Jaber, S. (2014). How to choose an anesthesia ventilator?. Annales francaises d’anesthesie et de reanimation, 33(7-8), 462–465. https:// doi.org/10.1016/j.annfar.2014.07.006

6 – Cameron, P. D., & Oh, T. E. (1986). Newer modes of mechanical ventilatory support. Anesthesia and intensive care, 14(3), 258–266. https://doi.org/10.1177/0310057X8601400306

respiratory-care-blog-post

What is Respiratory Care: Trends and Advancements

by with No Comment Uncategorized

Patients with severe respiratory disorders frequently require specialized care in the Intensive Care Unit (ICU), a vital area in healthcare. The field of respiratory care advances in tandem with medical science. The future of respiratory care is closely tied to virtual care technology. As we explore changes in respiratory health, it’s clear that new and improved virtual care solutions are shaping how we approach diagnosis and treatment.

This blog explores cutting-edge developments in respiratory care that have the potential to completely transform the way we diagnose, manage, and treat respiratory conditions.

ICU In The Context Of Respiratory Care

A cooperative team of medical experts, comprising doctors, nurses, and the vital respiratory therapist, collaborates in the dynamic Intensive Care Unit (ICU) to deliver unmatched care to patients in critical condition. Their proficiency encompasses various tasks, including complex ventilator control, diagnostic blood drawing, and bronchoscopy support. Specialized gas administration including treatments such as heliox and nitric oxide and careful attention to every aspect of hemodynamic monitoring highlight the respiratory therapist’s vital roles in this high-stakes setting. [1]

Respiratory Care Personalized Medicine

Personalized medicine is a cutting-edge approach that customizes medical treatments based on a person’s genetic composition, lifestyle, and surroundings. It refers to creating respiratory care plans specially tailored to every patient’s requirements. Pharmacogenomics, which identifies the safest and most effective drugs for specific patients, is one possible example. Genetic differences can affect a person’s response to a drug, so adjusting a medication’s dosage could significantly improve treatment results.

Wearable technology developments are crucial for real-time patient monitoring, respiratory pattern data collection, and individualized interventions or feedback. Intelligent inhalers, which track medication compliance and offer instantaneous feedback, are invaluable for treating respiratory ailments. Pulmonary function tests are easily accessible with portable electronic spirometers, which close the gap between patient monitoring and diagnosis. Furthermore, digital stethoscopes that use artificial intelligence (AI) improve lung auscultation accuracy and offer useful diagnostic information. [2]

Machine Learning and AI in Radiation Therapy

Significant progress is being made in changing respiratory care through artificial intelligence (AI) and machine learning (ML). These technologies are adept at analyzing vast datasets with unprecedented speed and accuracy, offering clinicians valuable insights for treatment planning and decision-making. They help optimize ventilator settings for individual patients to predictive analytics for early disease detection.

AI is a valuable tool in predicting disease progression, enabling medical professionals to customize treatment regimens and interventions to improve patient outcomes. By utilizing extensive biological and clinical datasets, these technologies provide priceless insights for forecasting outcomes, individualized treatment planning, and disease prediction. One prominent example is the application of AI algorithms to the analysis of medical imaging, including CT and chest X-rays, for the early diagnosis of respiratory disorders. Diagnoses can be made more quickly and accurately thanks to these systems’ ability to spot irregularities and subtle patterns that the human eye might miss. [3]

How does AI help respiratory medicine?

The revolutionary collaboration of AI, ML, and respiratory medicine advances our knowledge of disease mechanisms, expedites drug development, and improves personalized therapies.

AI helps: 

  • Diagnose and treat lung cancer
  • Evaluate fibrotic lung diseases
  • Interpret pulmonary function tests and manage COPD
  • Aids in prioritizing possible therapies
  • Predicting the structures of infectious proteins 
  • Drug discovery

Even with the encouraging results, cautious application of AI in clinical practice is still necessary due to data quality, validation, and ethical issues. [4]

AI & ML together facilitate adaptive treatment planning by continuously learning from patient responses, enabling dynamic adjustments to therapy regimens in real time.

Developments in Biotechnology: Gene Therapy, Stem Cells, and Regenerative Medicine

Gene therapy, leveraging the precision of genetic manipulation, holds the promise of treating and potentially curing a spectrum of genetic disorders by correcting or replacing faulty genes. Stem cell therapies use the regenerative power of versatile cells to repair and regenerate injured lung tissues.

Imagine a time when lung cell-regenerating therapies will be available to patients with chronic respiratory diseases, improving their overall quality of life and lung function. The swift advancement in stem cell research presents great potential for regenerative medicine. It highlights the potential uses of induced pluripotent stem cells (iPSCs) for the treatment of lung and liver diseases, with an emphasis on lung degeneration and Alpha-1 Antitrypsin Deficiency (A1AD). [5]

iPSCs are used to treat diseases like cancer, fibrosis, and tuberculosis in the context of lung degeneration. It is suggested that lung tissue can be restored by transplanting induced pluripotent stem cells (iPSCs) that resemble alveoli and airways. This model is recommended for drug testing, and addressing lung and liver degeneration, it may help improve the treatment of chronic obstructive pulmonary disease (COPD). To address the lack of donor organs, researchers are also looking into 3D bioprinting to create artificial lungs or lung components for transplantation.

Environmental Aspects: Inhaling Clean Air to Promote Respiratory Health

Ensuring a healthier environment for respiratory patients requires investigating green technologies, supporting clean air initiatives, and creating intelligent living environments that reduce respiratory triggers.

Healthcare professionals can use environmental data to personalize recommendations for patients, assisting them in avoiding potential triggers and better managing their respiratory conditions as more advanced sensors and monitoring devices are developed.

Ethical and Regulatory Aspects: Juggling Innovation and Accountability

Addressing ethical and regulatory issues as personalized medicine and AI integration transforms the respiratory care landscape is critical. Nailing the ethical problems posed by these developments requires maintaining transparency in AI algorithms, protecting data privacy, and striking a balance between innovation and patient safety. Building trust between patients and healthcare professionals will require the creation of clear protocols for handling patient data and the development of standardized guidelines for the moral application of AI in respiratory care.

The ethical implications of applying artificial intelligence (AI) to respiratory care demand a thorough analysis of the risks and difficulties involved. Although the merging of technology and healthcare holds great potential for progress, it also raises moral questions that affect medical AI’s dependability and credibility.

Challenges and Barriers in Respiratory Care

Respiratory care, while advancing rapidly, faces a spectrum of challenges and barriers that demand attention and innovative solutions. The challenges encompass a range of issues, such as:

  • Algorithmic bias perpetuates health disparities,
  • Unstructured medical data affecting algorithm quality,
  • Opaque algorithms undermining trust,
  • Possible hazards to patient autonomy.

Other challenges include:

  • The increasing prevalence of respiratory diseases,
  • Increased strain on healthcare systems and resources,
  • Keeping up with the technological advancement to avoid integration barriers,
  • Affordability and accessibility issues limiting access to healthcare,
  • Fragmented healthcare hinders seamless communication.

While regulations concentrate on risk management, algorithm transparency, and data quality, legal frameworks must define accountability. In the quickly changing field of medical AI, international cooperation is crucial for a comprehensive and globally applicable ethical governance system. [6]

Bringing Respiratory Care to Life

There are a lot of fascinating opportunities for respiratory care in the future. AI, biotechnological developments, personalized medicine, and an emphasis on environmental factors can transform how we diagnose and treat respiratory diseases thoroughly. It’s critical to negotiate the ethical, legal, and financial terrain as we enter this uncharted area to ensure that these innovations result in better outcomes and a breath of fresh air for patients in need.

In the future of ICUs, Artificial Intelligence is changing the game. It’s not just a trend; it’s a big step forward for better and more precise care, making critical care even more advanced and effective.

Introducing the Biyovent ICU Ventilator

A revolutionary advancement in respiratory care. What sets Biyovent apart are its exceptional specifications, meticulously crafted to elevate the ventilation process to unprecedented heights. Every aspect of Biyovent has been carefully considered and developed with a holistic approach, ensuring a comprehensive solution for optimal patient care.

In a strategic collaboration with industry leaders Arçelik, Baykar, and Aselsan, Biyovent is not only the result of cutting-edge innovation but is also poised for streamlined mass production. This partnership underscores a commitment to delivering state-of-the-art technology, setting a new benchmark in ventilator design and functionality.

Experience the future of respiratory support with Biyovent ICU Ventilator – where precision meets performance, and healthcare reaches new horizons.

References

[1] Critical Care Therapy and Respiratory Care Section (CCTRCS) | Clinical Center Home Page. (n.d.).: https://www.cc.nih.gov/ccmd/services/cctrcs.html#:~:text=Intensive%20Care%20Unit%3A,to%20most%20critically%20ill%20patient.
[2] Honkoop, P., Usmani, O., & Bonini, M. (2022, April 26). The Current and Future Role of Technology in Respiratory Care. Pulmonary Therapy; Adis, Springer Healthcare. https://doi.org/10.1007/s41030-022-00191-y 
[3] Hosny, A., Parmar, C., Quackenbush, J., Schwartz, L. H., & Aerts, H. J. (2018, May 17). Artificial intelligence in radiology. Nature Reviews Cancer; Nature Portfolio. https://doi.org/10.1038/s41568-018-0016-5
[4]Applications of AI, Machine Learning, Computational Medicine, and Bioinformatics in Respiratory Pharmacology. (n.d.). Frontiers. https://www.frontiersin.org/research-topics/58254/applications-of-ai-machine-learning-computational-medicine-and-bioinformatics-in-respiratory-pharmacology 
[5] Mahla, R. S. (2016, January 1). Stem Cells Applications in Regenerative Medicine and Disease Therapeutics. International Journal of Cell Biology; Hindawi Publishing Corporation. https://doi.org/10.1155/2016/6940283 
[6]Zhang, J., & Zhang, Z. (2023, January 13). Ethics and governance of trustworthy medical artificial intelligence. BMC Medical Informatics and Decision Making; BioMed Central. https://doi.org/10.1186/s12911-023-02103-9

mechanical-ventilation-and-ICU-ventilators

Mechanical Ventilation and ICU Ventilators: Learn All Details

by with No Comment Uncategorized

Mechanical ventilation and ICU ventilators are critical components in the management of patients with severe respiratory conditions. Understanding their functionality and application is essential for effective patient care. These technologies play an important role in supporting and stabilizing patients in critical conditions.

What is Ventilation? 

ICU Ventilation is the process of movement of air from the atmosphere through the airways to the terminal respiratory gas exchange units by the effort of the respiratory muscles or mechanical ICU ventilators if the patient is being ventilated. 

What is Respiration? 

Oxygen is essential for life. It is required by each human cell for its survival. It is abundantly present in the atmosphere and maintains a remarkably constant concentration of 20.9% in ambient air. Oxygen is taken up by the lungs through the act of inspiration and transported to the cells via the blood.

At the cellular level, oxygen is utilized for the production of energy. In this process, carbon dioxide is released and transported back via the blood to the lungs from where it is expired out into the atmosphere. The act of the exchange of oxygen and carbon dioxide is called respiration. 

What is the Difference Between ICU Ventilators and Respirator? 

A ventilator is a machine, a system using mechanical power and having several parts, each with a definite function and together performing a particular task. The task here is to provide all or part of the body’s work that is called breathing or ventilation. Respirator is an apparatus that people worn it over their mouth and nose or the entire face to prevent the inhalation of dangerous substances such as: dust, smoke, etc

Indications for Ventilation

Patients who require ventilatory support often develop a common pattern of physiological deterioration, including:

  • changes in respiratory rate
  • asynchronous respiratory pattern
  • changes in mental status and changes in level of consciousness
  • frequent oxygen desaturation despite increasing oxygen concentration
  • hypercapnia and respiratory acidosis
  • circulatory problems, including tachypnea, tachycardia, hypertension, or hypotension.(3)

What is Non-invasive Ventilation (NIV)?

NIV refers to the provision of respiratory support without direct tracheal intubation. As such, it aims to avoid some of the complications inherent with invasive ventilation, such as the need for sedation with risks of hemodynamic instability and subsequent risk of delirium, nosocomial infection, etc.(2)

Recommendations for the use of non-invasive ventilation(4):

  • COPD exacerbations
  • Facilitation of weaning/extubation in patients with COPD
  • Cardiogenic pulmonary edema
  • Immunosuppressed patients
  • Do-not-intubate status
  • End-stage patients as palliative measure
  • Extubation failure (COPD or congestive heart failure) (prevention)
  • Community-acquired pneumonia in COPD
  • Postoperative respiratory failure (prevention and treatment)
  • Prevention of acute respiratory failure in asthma

Goals of Mechanical Ventilation

One of the most important treads of life support in the emergency department is Mechanical ventilation (MV). It provides time for recovery until the patient’s physiological balance is restored. This is why MV alone is not a unique and specific treatment for a particular disease; however, it has two general and main purposes: to support the injured lung and to protect the healthy lung.

Specific Goals of Mechanical Ventilation

  • Reversal of Apnea
  • Reversal of Respiratory Distress
  • Reversal of Severe Hypoxemia
  • Reversal of Severe Hypercapnia
  • Goals of Mechanical Ventilation in Postoperative
  • Respiratory Failure and Trauma
  • Goals of Mechanical Ventilation in Shock

One of the specific goals of MV is to promote the optimization of arterial blood gas levels and acid-base balance by providing oxygen and eliminating carbon dioxide (ventilation).(1) For patients with chronic diseases MV can reduce the work of breathing by taking effort from respiratory muscles and maintaining long-term respiratory support.
The ventilator is not a magical therapy that makes patients better but simply a supportive therapy used until more definitive therapies have time to work.

Apnea

Patients with apnea, such as those who have suffered catastrophic central nervous system (CNS) damage, need the immediate institution of mechanical ventilation.(2)

Indications and Contraindications for Non-invasive Ventilation

Recognizing when and when not to use NIV is crucial for its effective application. Below, we have explained the indications and contraindications for non-invasive ventilation for you

Indications (3)

  • Moderate to severe dyspnoea
  • Tachypnoea (>25–30 breaths/minute)
  • Signs of increased work of breathing (abdominal paradox; accessory muscle use)
  • Fatigue
  • Acute-on-chronic respiratory failure: pH <7.35; pCO2 >6
  • Hypoxaemia (use with caution): paO2/FiO2 <27 Kpa

Contraindications (3)

  • Facial burns/trauma/recent facial upper airway surgery
  • Vomiting
  • Upper gastrointestinal surgery
  • Copious respiratory secretions
  • Severe hypoxemia
  • Hemodynamically instability
  • Severe co-morbidities
  • Confusion/agitation
  • Low Glasgow coma score
  • Unable to protect the airway
  • Bowel obstruction
  • Respiratory arrest

NIV today consists almost exclusively of the delivery of positive pressure ventilation via an external interface. There are six broad types of interfaces available;

  • total face masks (enclose mouth, nose, eyes)
  • full-face masks (enclose mouth and nose)
  • nasal mask (covers nose but not mouth)
  • mouthpieces (placed between lips and held in place by lip seal)
  • nasal pillows or plugs (inserted into nostrils)
  • helmet (covers the whole head/all or part of the neck – no contact with face).(3)

What is Invasive Ventilation?

Invasive mechanical ventilation requires access to the trachea, most commonly via an endotracheal tube, and represents the commonest reason for admission to the ICU.(5)ICU Ventilators.

Large multinational surveys confirm the common indications for invasive ventilation to be:

  • coma 16%
  • COPD 13%
  • ARDS 11%
  • heart failure 11%
  • pneumonia 11%
  • sepsis 11%
  • trauma 11%
  • postoperative complications 11%
  • neuromuscular disorders 5%.
  • NIV contraindications.(5)

Let’s Meet with Biyovent ICU Type Mechanical Ventilator

ICU Ventilators

Biyovent ICU Type Mechanical Ventilator

ICU Ventilator of Biyovent makes a difference in the ventilation process with its unique specifications. Biyovent has been carefully thought out with every detail of the ventilators and developed with a holistic approach. Prepared for mass production in cooperation with Arçelik, Baykar, and Aselsan. ICU Ventilators

What are some specific features of Biyovent?

⦁ Invasive and Non-invasive Ventilation
⦁ Integrated Nebulizer
⦁ High Flow Oxygen Therapy
⦁ Suitable for Pediatric, Adult and Newborn (Optional) Patients
⦁ Smart Ventilation Modes

Learn more details about Biyovent ICU Ventilator

Get in contact with the Biosys Sales Team

References


1- Frank Lodeserto MD, “Simplifying Mechanical Ventilation – Part I: Types of Breaths”, REBEL EM blog, March 8, 2018. Available at: https://rebelem.com/simplifying-mechanical-ventilation-part/.
2- Tobin M.J. 3rd edn. McGraw-Hill Education; 2012. Principles and practice of mechanical ventilation.
3- Popat B, Jones AT. Invasive and non-invasive mechanical ventilation. Medicine (Abingdon). 2012;40(6):298-304. doi:10.1016/j.mpmed.2012.03.010
4- Hess D.R. The evidence for noninvasive positive-pressure ventilation in the care of patients in acute respiratory failure: a systematic review of the literature. Respir Care. 2004;49:810–829.
5- Esteban A., Ferguson N.D., Meade M.O. Evolution of mechanical ventilation in response to clinical research. Am J Respir Crit Care Med. 2008;177:170–177