July 2012 541

Sophistication Matters!

“Over the years ventilators have evolved to be sophisticated, automated platforms, which adapt to the  patient rather than just work as pumps,” says Dr Vikram Khatri, Consultant – Intensive Care Unit Moolchand Medcity.

Ventilator technology is a strong pillar of modern medicine. These   machines are critical for the  modern doctors to help  their patients.  It used be as a sure sign of terminal illness and impending death, but is now  used prophylactically and are Critical in  providing a secure, reliable and efficient  respiratory support to the patients in variety of clinical settings. They reused  in stabilising patients with respiratory  disease and to provide support in other   medical conditions until they  get  resolve.   Essentially ventilators are machines with the ability to deliver oxygen, pressure  and volume to the lungs.

Synchrony with the patient
Newer ventilators are very sensitive to patients’ breathing effort and terminate breath or deliver or cease support with almost no lag. This reduces the need for sedation in a ventilated patient.

Pressure and flow regulation
Newer challenges such as harm associated with high pressures have been controlled with the limitation of pressure applied to the lungs, at the same time ensuring the delivery of the appropriate volume with active changes in the flow atterns. Technologies like Autoflow, PRVC, olume guarantee, among others have emerged and matured.

Adaptive support
Previously it took a physician/clinician to decide clinically, the appropriateness of the support and change it accordingly, now the ventilators have been designed to adapt to the patients increasing and decreasing demands. The newer  machines do this by sensing the flow pattern and the pressure gradients generated by the patient. Algorithms like MMV, adaptive upport ventilation, smart care etc are popular now.

Monitoring
We have had a tremendous increase in the ability of the ventilators. They help the physician in measuring lung ynamics, ressures, autopeep, and inspiratory and expiratory holds. Also, newer ventilators have incorporated VCO2 and EtCO2. This new technology helps monitor the adequacy of ventilation, which is critical in some situations like those common in neurosurgery and avoids frequent blood gas measuring in the others.

Newer methods
Acute respiratory distress syndrome and other such conditions in which the traditional modes of ventilation failed now have some chance, thanks to modes like APRV and unique ventilation technology namely high frequency oscillation. hey differ from the traditional mode of blowing oxygen mix in the lungs. APRV keeps the lungs at a fixed volume and eleases the pressure periodically. High frequency oscillating technology oscillates the lungs and achieves oxygenation nd ventilation. Initially popular in children it is now gaining foothold in the adult world of medicine


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