Mechanical Ventilation Devices (IVL)

How the IVL apparatus works

An artificial ventilation device lungs (IVL), as the name implies, is a specialized medical device for mechanical participation in the external respiration of a person. With the help of some mechanical device, the respiratory mixture is supplied into the respiratory tract in conjunction with spontaneous breathing or completely replacing the function of external breathing. The design and operation of such a device is directly related to the field of application and place in the complex of medical technologies used in the hospital.

When a person needs an artificial ventilation apparatus, the medical professional introduces an endotracheal tube (ET tube) through the nose or mouth of the patient and inserts it into the respiratory throat (trachea). The tube is then connected to a ventilator. Endotracheal tube and mechanical ventilation apparatus perform different work. The fan pumps a mixture of air and oxygen into the patient's lungs to deliver oxygen to the body.

The IVL can also maintain a constant low pressure, called end-of-exhalation positive pressure (PEEP), to keep air bags in the lungs, this is necessary to ensure that air bags do not break down. The endotracheal tube allows doctors and nurses to remove mucus from the respiratory throat by suction. If a person has a tracheal blockage, for example, due to a tumor or a person requires an IVL apparatus for a long period of time, then a tracheostomy procedure may be needed. During a trakheostomiya the surgeon does an opening in a neck and the patient's trachea, and then inserts into an opening a respiratory tube, the called trakheostomichesky tube in an opening. The tracheostomy tube is then connected to the IVL set. The tube may remain as long as necessary, but it should not be permanent and can be removed if the patient no longer needs it. At the same time, a person can talk and eat with a tracheostomy tube.

Places of use of the HIA set

• In the ICU.
• In the department of anesthesiology and intensive care.
• In the postoperative department.

Most patients on the IVL apparatus are monitored in the intensive care unit. Any patient on an IVL device in the ward will be connected to a monitor that measures heart rate, respiratory rate, blood pressure and oxygen saturation. Other studies that can be done include chest radiography and blood sampling to measure oxygen and carbon dioxide. Members of the medical team (including doctors, nurses, respiratory therapists) will use this information to assess the condition of the patient and make adjustments to the operation of the ventilator if necessary.

Types of IVL sets

As Zdrav.expert explained, a representative of one of the companies operating in the market of intravenous devices, such equipment can be divided into the following types:

• IVL devices for intensive care are the most common and popular solution for the workplace of a resuscitator in intensive care and intensive care units. We often see these devices in public space (for example, in news and cinema) and it is with this class of devices that the efforts of doctors in the struggle for the lives of their patients are associated. According to the types of patients, such devices are usually divided into devices for children and adults, as well as for newborns and premature infants. There are also universal models for all patient groups. In addition, specialized devices are used for complex techniques, such as high-frequency and inkjet ILV.

• Specialized devices for the so-called "subacute" respiratory therapy. Their use is possible not only in intensive care and intensive care, but also in other clinical specializations not related to the complete replacement of breathing autonomy. This includes high-oxygen mask therapy, inhalation of various drugs, breathing disorders therapy in dream and a number of other areas.

• INTL transport devices are mobile devices designed to move patients to the INTL. These devices are able to function autonomously both for a short time, when moving inside the hospital, and for significant periods when transporting patients outside medical institutions in special transport by land, water and air. Most often used for emergency assistance.

• Anesthesia and respiratory devices are one of the most numerous groups of intravenous devices. These devices are designed to provide an anesthesiological aid and allow not only to replace your own breath, but also to deliver inhalation anesthesiological substances with a respiratory mixture. The equipment is used in operating rooms and is vital to ensure painless and safe surgical treatment.

• Home ventilation machines. A special class of equipment with the simplest control, which does not require special knowledge. Necessary for patients who need constant respiratory support, but they may be out of hospital. Usually, the work of such equipment is supported by special private or public entities.

Who is assigned an IVL

• With sudden arrest of blood circulation in the patient.
• With mechanical respiratory asphyxiation in the patient.
• Severe chest damage or patient brain damage.
• Severe and superheavy degrees of intoxication in patients.
• With a strong decrease in blood pressure.
• Severe asthma exacerbation.
• Shock conditions in the patient, including cardiogenic ones.
• First aid cases.
• Bronchoscopy or anesthesia.
• Need for neonatal respiratory recovery.

Risks in the use of ILV

Mechanical ventilation devices are specialized equipment that is unacceptable to use without an expert doctor in this area. Our own breathing seems easy to understand. But a slightly more detailed immersion in the physiology of human external respiration allows us to see how difficult this system of our body is. Diseases and their manifestations, which affect the respiratory system, are even more diverse.

According to the interlocutor of Zdrav.expert, it is extremely difficult to correctly assess the state of breathing, to choose the optimal solution for respiratory therapy. The effectiveness of the IVL is obvious, but unfortunately, the safety of using mechanical ventilation of the lungs still requires special attention and control. Another feature of IVL is that despite the huge progress in development, the actual mechanical inflation of the lungs is very different from natural respiration. Doctors are forced, in addition to fighting the disease itself, which required the use of IVL, to also concentrate their efforts on overcoming the undesirable effects associated with the non-physiology of this technology. Here it is very important that the used VIA devices allow to implement a strategy of "protective VIA," that is, they have tools and special algorithms that allow to minimize the undesirable effects of mechanical ventilation and protect the patient's lungs.

Problems that may develop as a result of the use of the HIA apparatus include:

• Infections - Patients on an IVL device are more likely to get pneumonia, which can become a serious problem. The patient may need to stay on the IVL apparatus for longer while pneumonia is treated with antibiotics.
• Lung collapse (pneumothorax) - Sometimes part of the lung can become weak and a hole forms through which air leads to collapse of the lung. If the lung collapse is severe enough, it can lead to death. In order to expand the lung, it is necessary to place a tube (chest tube) in the chest to discharge the leaking air. When the lung heals, the tube can be removed.
• Lung damage - The pressure of the air injected into the lungs by means of an IVL device can damage the lungs. Doctors try to minimize this risk by using the minimum necessary pressure that is needed. Very high oxygen levels can also be harmful to the lungs. Doctors give only as much oxygen as necessary to make sure the body receives enough to feed vital organs. Sometimes it is difficult to reduce this risk when the lungs are damaged. However, this damage can be cured if a person can recover from a serious illness.
• Side effects of drugs - Sedatives and painkillers can cause confusion or delusions in a person, and these side effects can continue even after the medication stops. The medical team is trying to pick up the right amount of drugs for a person. Different people will respond differently to each medicine, and if a medicine is required to prevent muscle movement, the muscles may be weak for some time after the medication is stopped. Over time, this may pass. Unfortunately, in some cases, weakness persists for weeks or months.
• Inability to stop supporting IVL due to an illness from which a person needed to connect to the device. When this happens, the medical team will discuss treatment preferences regarding continued support on the device. Often, the medical team conducts such discussions with family members or the patient himself, if he is able to participate in the discussion. In situations where a person is not recovering or is getting worse, it may be decided to stop supporting the IVL apparatus and allow death to occur.

How Long the HLV Set Has Been Used

IVL can save a life, but its use is fraught with risk. The device does not eliminate the problem that led to the fact that the person needed an IVL device, the device helps to support the person until the patient is in serious condition or until the person recovers himself.

The medical team always tries to help a person disconnect from an IVL device as soon as possible. By disconnection, refers to the process of releasing the patient from the device, some patients may be on the device for only a few hours or days, while others may need the device for a longer period of time. How long a patient should be on an IVL depends on many factors. The data may include the general state of the body, how well the lungs were developed before the patient got into the IVL apparatus, as well as how many other organs are affected (for example,, brain heart or otherwise). kidneys The condition of some people never improves enough to be removed from the device.

How the patient feels while on the IVL apparatus

The IVL device itself does not cause pain, but the tube can cause discomfort, as it can cause coughing or vomiting calls. A person cannot speak when an IVL tube passes between the vocal cords into the respiratory throat. The patient also cannot eat through the mouth when the tube is installed, can also feel discomfort when air is injected into the lungs. Sometimes a person will try to exhale when the device is trying to force air, this makes it difficult for the device to work.

People on IVL devices can be given drugs (sedatives or painkillers) to make them feel more comfortable. These medications can also cause drowsiness. Sometimes, drugs that temporarily prevent muscle movement (neuromuscular blockers), it is necessary for the device to do all the work for the patient. These drugs are commonly used when a person has very severe lung damage; their reception is stopped as soon as possible and always until the HIA device is disconnected.

Market of IVL devices

• Ventilators (Russian market)
• Ventilators (global market)