Artificial ventilation

Source: Wikipedia, the free encyclopedia.
Artificial ventilation
Intensive Care Unit.
Other namesartificial respiration
Specialtypulmonary
]

Artificial ventilation or respiration is when a machine assists in a metabolic process to exchange gases in the body by pulmonary ventilation, external respiration, and internal respiration.[1] A machine called ventilator provides the person air manually by moving air in and out of the lungs when an individual is unable to breathe on their own. The ventilator prevents the accumulation of carbon dioxide so that the lungs don't collapse due to the low pressure.[2][3] The use of artificial ventilation can be traced back to the seventeenth century. There are three ways of exchanging gases in the body: manual methods, mechanical ventilation, and neurostimulation.[4]

Here are some key words used throughout the article. The process of forcing air into and out of the lungs is known as ventilation. The process by which oxygen is taken in by the bloodstream is called oxygenation. Lung compliance is the capacity of the lungs to contract and expand. The obstruction of airflow via the respiratory tract is known as airway resistance. The amount of ventilated air that is not involved in gas exchange is known as dead-space ventilation.[5][tone]

Types

Manual methods

Further information: Mouth-to-mouth resuscitation

Pulmonary ventilation is done by manual insufflation of the lungs either by the rescuer blowing into the patient's lungs (

Silvester method.[7]

Mechanical ventilation

Main article: Mechanical ventilation

Mechanical ventilation is a method to mechanically assist or replace spontaneous

trachea, and negative pressure ventilation, where air is, in essence, sucked into the lungs.[10]

oropharynx
and subglottic stenosis.

In an emergency a

tracheostomy but a cricothyrotomy is reserved for emergency access. This is usually only used when there is a complete blockage of the pharynx or there is massive maxillofacial injury, preventing other adjuncts being used.[11]

Neurostimulation

Main article: Diaphragm pacing

A rhythmic pacing of the diaphragm is caused with the help of electrical impulses.[12][13] Diaphragm pacing is a technique used by persons with spinal cord injuries who are on a mechanical ventilator to aid with breathing, speaking, and overall quality of life. It may be possible to reduce reliance on a mechanical ventilator with diaphragm pacing.[14] Historically, this has been accomplished through the electrical stimulation of a phrenic nerve by an implanted receiver/electrode,[15] though today an alternative option of attaching percutaneous wires to the diaphragm exists.[16]

History

The Greek physician

trachea of animals.[18]

It wasn't until 1773, when an English physician William Hawes (1736–1808) began publicizing the power of artificial ventilation to resuscitate people who superficially appeared to have drowned. For a year he paid a reward out of his own pocket to any one bringing him a body rescued from the water within a reasonable time of immersion. Thomas Cogan who was another English physician had become interested in the same subject during a stay at Amsterdam.

In the summer of 1774, Hawes and Cogan each brought fifteen friends to a meeting at the Chapter Coffee-house in

St Paul's Churchyard, where they founded the Royal Humane Society. Some methods and equipment were similar to methods used today, such as wooden pipes used in the victims nostrils to blow air into the lungs. Or the use of bellows with a flexible tube for blowing tobacco smoke through the anus to revive vestigial life in the victim's intestines, which was discontinued with the eventual further understanding of respiration.[19]

The work of English physician and physiologist

Edward Sharpey Schafer.[20] It involved placing the patient on his stomach and applying pressure to the lower part of the ribs. It was the standard method of artificial respiration taught in Red Cross and similar first aid manuals for decades,[21] until mouth-to-mouth resuscitation became the preferred technique in mid-century.[22]

The shortcomings of manual manipulation led doctors in the 1880s to come up with improved methods of mechanical ventilation, which included Dr. George Edward Fell's "Fell method" or "Fell Motor."[23] It consisted of a bellows and a breathing valve to pass air through a tracheotomy. He collaboratied with Dr. Joseph O'Dwyer to invent the Fell-O'Dwyer apparatus, which is a bellows instrument for the insertion and extraction of a tube down the patients trachea.[24][25] Such methods were still looked upon as harmful and were not adopted for many years.

In 2020, the supply of mechanical ventilation became a central question for public health officials due to

2019–20 coronavirus pandemic related shortages
.

See also

References

  1. PMID 16534315
    .
  2. ^ Tortora GJ, Derrickson, Bryan (2006). Principles of Anatomy and Physiology. John Wiley & Sons Inc.
  3. ^ "medilexicon.com, Definition: 'Artificial Ventilation'". Archived from the original on 2016-04-09. Retrieved 2016-03-30.
  4. PMID 17192523
    . Retrieved 2024-03-08.
  5. PMID 8038293
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  6. PMID 30111343
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  7. ^ "Artificial Respiration". Microsoft Encarta Online Encyclopedia 2007. Archived from the original on 2009-10-30. Retrieved 2007-06-15.
  8. ^ "What Is a Ventilator? - NHLBI, NIH". www.nhlbi.nih.gov. Retrieved 2016-03-27.
  9. ^ GN-13: Guidance on the Risk Classification of General Medical Devices Archived May 29, 2014, at the Wayback Machine, Revision 1.1. From Health Sciences Authority. May 2014
  10. PMID 17962636
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  11. PMID 11904254
    . Retrieved 2007-05-19.
  12. ^ Bhimji, S. (16 December 2015). Mosenifar, Z. (ed.). "Overview - Indications and Contraindications". Medscape - Diaphragm Pacing. WebMD LLC. Retrieved 19 February 2016.
  13. ISBN 978-3-319-25448-7
    . Retrieved 19 February 2016.
  14. PMID 27195135
    .
  15. S2CID 12142444
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  16. ^ "Use and Care of the NeuRx Diaphragm Pacing System" (PDF). Synapse Biomedical, Inc. Archived from the original (PDF) on 19 February 2016. Retrieved 19 February 2016.
  17. ISBN 978-0-07-144767-6
    .
  18. PMID 14703040
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  19. ^ "A Watery Grave- Discovering Resuscitation, exhibits.hsl.virginia.edu". exhibits.hsl.virginia.edu. Archived from the original on 2017-01-06. Retrieved 2016-03-30.
  20. ^ "Sir Edward Albert Sharpey-Schafer". Encyclopaedia Britannica. Retrieved 8 August 2018.
  21. ^ American National Red Cross (1933). American Red Cross First Aid Text-Book (Revised). Philadelphia: The Blakiston Company. p. 108.
  22. S2CID 2547073
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  23. ^ Angela Keppel, Discovering Buffalo, One Street at a Time, Death by Electrocution on Fell Alley?, buffalostreets.com
  24. ^ STEVEN J. SOMERSON, MICHAEL R. SICILIA, Historical perspectives on the development and use of mechanical ventilation, AANA Journal February 1992/Vol.60/No.1, page 85
  25. ^ 19th century pioneers of intensive therapy in North America. Part 1: George Edward Fell, Crit Care Resusc. 2007 Dec;9(4):377-93 abstract

External links

Media related to Artificial respiration at Wikimedia Commons

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