Sophistication Matters!

Over the years ventilators have evolved to be sophisticated, automated platforms, which adapt to the patient rather than just work like 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 modern doctors to help their patients.  It used to 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 a variety of clinical settings. They reused in stabilizing patients with respiratory disease and to provide support in other medical conditions until they get resolved.   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 patterns. Technologies like Autoflow, PRVC, volume 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 support ventilation, smart care, etc are popular now.

We have had a tremendous increase in the ability of the ventilators. They help the physician in measuring lung dynamics, pressures, auto peep, 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 releases the pressure periodically. High-frequency oscillating technology oscillates the lungs and achieves oxygenation and ventilation. Initially popular in children it is now gaining a foothold in the adult world of medicine



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