What Is Ventilator Management?

Invasive ventilator is a type of ventilator, also known as multifunctional ventilator. It is used to support the breathing of the human body or other animals when the organism's spontaneous breathing cannot meet the normal physiological needs.

Invasive ventilator

Invasive

Invasive

How the ventilator works

The working principle of the ventilator is an artificial mechanical ventilation device to assist or control the patient's voluntary breathing movement to achieve the function of gas exchange in the lungs, reduce the consumption of the human body, and facilitate the recovery of respiratory function.

How non-invasive ventilator works

When inhaling, the ventilator presses air into a person's lungs through a certain high pressure, and when exhaling, the machine gives a lower pressure to let people expel CO2 from the mouth or nose through the exhaust hole on the mask. To complete a breath

Difference and connection between non-invasive ventilator and invasive ventilator

With the clinical application of new theory and technology of mechanical ventilation, the research results of many evidence-based medicines constantly rewrite the concept of clinical medical staff, making it necessary for us to update our views and re-understand the non-invasive and invasive positive-pressure mechanical ventilation technology. Respiratory failure is a traditional and new topic.

First, the difference and connection of non-invasive positive pressure mechanical ventilation:

Positive pressure mechanical ventilation for clinical application includes noninvasive and invasive (Invasive) ventilation. Noninvasive positive pressure ventilation (NPPV) refers to a positive pressure mechanical ventilation method without the need to establish an artificial airway. Clinically, an oral and nasal mask or nasal mask is used for positive pressure ventilation. In addition, full-face masks and nasal plugs are also used. Way for NPPV treatment. Invasive mechanical ventilation (IMV) refers to the method of positive pressure mechanical ventilation through the establishment of artificial airways (nasal or oral tracheal intubation, tracheotomy). Compared with invasive ventilation, noninvasive ventilation has the characteristics of simple setting, easy acceptance by patients, and secondary lung injury and lung infection, but it also has poor man-machine synchronization, unstable tidal volume, and is not conducive to airway secretion drainage. Such shortcomings are summarized as follows (Table 1) [1,3,4,5]:

Table 1: Difference between non-invasive and invasive ventilator

Easy to connect and carry

	Non-invasive ventilator	Invasive ventilator
Ventilator difference	Small size and simple panel High flow, low pressure, and good leak compensation Simple alarm setting	Large volume and complicated panel Low flow, high pressure, poor leak compensation Perfect monitoring and alarm settings
Connection method of ventilator	Oral and nasal masks, nasal masks, full face masks, etc.	Oral, nasal intubation or tracheotomy
Mechanical ventilation mode	Less, BiPAP (Bi-level, I / E), CPAP, etc.	More, VCV, PCV, SIMV, PSV, etc.
For patients	Patients with mild to moderate respiratory failure	Patients with severe respiratory failure
Application range	Intensive care unit, general ward, family	Intensive care unit
advantage	Preserving the patient's normal physiological functions (speaking, expectoration, eating, etc.) Less pain and tolerance Avoid complications of invasive mechanical ventilation Avoid or reduce the use of sedatives Relatively low medical expenses	Good pipeline sealing performance Good man-machine cooperation With air oxygen mixture, you can accurately set the concentration of inhaled oxygen Easy airway management Complete ventilation parameters and alarm settings can ensure accurate ventilation and detect problems in a timely manner
Disadvantage	Poor air tightness and easy to leak Simple alarm setting There is no air-oxygen mixture, so it is impossible to set the oxygen concentration accurately. Not conducive to drainage of airway secretions Insufficient gas heating and humidification Large dead space Easy to cause bloating	Easy to cause facial damage Complex pipeline connection, bulky Inability to retain patients' normal physiological functions Patients are poorly tolerated and often require sedation or muscle relaxants Complications related to mechanical ventilation are common (injury of the nasal mucosa and vocal cords, ventilator-associated pneumonia, ventilator-associated lung injury, etc.) Some patients are prone to ventilator dependence Expensive medical expenses

Prospects

Although there are some differences between non-invasive and invasive mechanical ventilation, we should consider the two as two important methods for clinical treatment of respiratory failure or mechanical ventilation at different stages of a disease. Therefore, there is a difference between non-invasive and invasive ventilation. close relationship. For example, patients with AECOPD (acute exacerbation of chronic obstructive pulmonary disease) can be treated with NPPV in the early stage. If the disease is further exacerbated, IMV can be treated. Once the disease is alleviated, extubation can be continued in advance to avoid invasive mechanical ventilation complications. This is often the case in clinics. ICU doctors emphasize invasive ventilation and neglect noninvasive ventilation, and some doctors in the respiratory department have overemphasized the importance of noninvasive ventilation; and domestic and foreign literature also mostly separates noninvasive and invasive ventilation. Explain, this will inevitably lead to the artificial separation of the two. It is gratifying that in recent years, many scholars at home and abroad have paid more and more attention to the close relationship between noninvasive and invasive mechanical ventilation, and the correct application of the two will inevitably bring the gospel to more respiratory failure patients.