Chest-Wall Compliance

Once the limits have been reached, there is very little or no change that will occur in the response to any pressure change. This is figured out by using the equation of change in pressure and the change in volume. (Jardins, 2013) By using this equation it will help figure out how compliant the lungs are. This is critical in figuring lung dysfunctions and developing care for a patient. One of the major diseases that lowers the elastance of the lung and the most preventable is Chronic obstructive pulmonary disease (COPD). COPD is categorized with an increase of airway resistance and the loss of lung elasticity. As a restriction in airflow develops, it leads to the hyperinflation of the alveoli. Some other diseases that are caused by low elastic conditions and is related to Hooke’s law are traumatic chest injuries, pneumonia, pneumothorax, pleural effusion, acute respiratory distress syndrome, pulmonary edema, and interstitial lung disease. All of the disease and/or illness’s cause the pressure-volume curve to slide to the right very quickly and allows the lung elastic properties to decrease significantly. (Jardins, 2013)

Another important intervention was to maintain the head of the bed at 30-45 degrees and position L.M.’s left lung into a dependent position to improve ventilation and perfusion. L.M.’s O2 was decreased to 63 and her CO2 was increased to 50. According to the IHI, it is recommended to elevate the bed to 30- 45 degrees to improve ventilation. Patients that lay in the supine position have lower spontaneous tidal volumes on pressure support ventilation compared to those laying at more of an angle (Institute for Healthcare Improvement, 2012). In regards to positioning, when the least damaged portion of the lung is placed in a dependent position it receives preferential blood flow. This redistribution of blood flow helps match ventilation and perfusion, therefore, improving gas exchange (Lough, Stacy & Urden, 2010). Implementing these interventions combined with respiratory therapy, significantly improved the blood gas values for oxygen and carbon dioxide levels.

Both rapid, shallow breathing patterns and hypoventilation effect gas exchange. Arterial blood gases will be monitored and changes discussed with provider. Alteration in PaCO2 and PaO2 levels are signs of respiratory failure. Patient’s body position will be properly aligned for optimum respiratory excursion, this promotes lung expansion and improved air exchange. Patient will be suctioned as needed to clear secretions and maintain patent airways. The expected outcome is that the patient’s airway and gas exchange will be maintained as evidence by normal arterial blood gases (Herdman,

The presence of fluid in the alveolar space could potentially cause the lung capacity to be effected as well.

Air escaped from the lung into the pleural space. Eventually, enough air collected in the pleural space to cause the mediastinum to shift twoard the right. The collapsed left lung, increased intrapleural pressure, and rightward shift make it difficult to ventilate A.W.

Dimich-Ward, Helen, PhD; Michelle Lee Wymer, BSc; and Moira Chan-Yeung, MB. “Respiratory Health Survey of Respiratory Therapists” CHEST; Oct2004, Vol. 126 Issue 4, p1048-1053,

Patient outcome consisted of performing 10 deep breaths per hour. We have reviewed details that were difficult for the patient to remember, such as breathing out before placing the lips on the mouthpiece, and holding breath for 3 to 5 seconds at the top of each inhalation. With empathy, I provided understanding that being hospitalized is never easy due to sensory overload, pain and lack of privacy. Additionally, we have discussed the basic pathophysiology of lung inflammation and what it can do to a person. So overall, the outcome included enhanced disease knowledge with effective use of incentive spirometer.

There is a considerable controversy regarding the use of OBL in patients with respiratory failure and those on mechanical ventilation because of the potential high morbidity and mortality associated with its use in those patients (20, 21). While the role of OLB has become well established in the diagnosis of interstitial lung disease (18), its utility and safety are more controversial in critically ill patients. Proponents of OLB argue that solid diagnosis of underlying aetiology can be helpful in determination of the best course of treatment (22). Moreover, the risk of biopsy is fairly low if adequate precautions are taken (23). In contrast, opponents of OLB believe that defining the underlying mechanism of injury is largely academic and it will not add new to the treatment of those patients because of the lack of specific therapies for underlying aetiologies of ARDS and respiratory

The observation of both animal and humans has revealed that mechanical ventilation can cause severe lung injury if over-distention occurs (Roupie et al., 1995). To make the matter even worse, the very patients that need mechanical ventilation the most, patients with the acute respiratory distress syndrome for example, are especially susceptible to over-distention and therefore, lung injury (Stewart et al., 1998). The main reason that patients with acute respiratory distress syndrome or respiratory distress syndrome are in higher risk of lung injury is due to over-distention, caused by reduced numbers of alveoli as result of fluid buildup, consolidation, and atelectasis (Roupie et al., 1995).

Exercise 7: Respiratory System Mechanics: Activity 2: Comparative Spirometry Lab Report Pre-lab Quiz Results You scored 100% by answering 5 out of 5 questions correctly. 1. A normal resting tidal volume is expected to be around You correctly answered: d. 500 ml. 2. Which respiratory process is impaired the most by emphysema? You correctly answered: c. expiration 3. During an asthma attack You correctly answered: b. inspiration and expiration are impaired. 4. During moderate aerobic exercise, which respiratory variable increases the most? You correctly answered: a. tidal volume 5. Inhaler medications for an asthma patient are designed to You correctly answered: b. dilate the patient's bronchioles.

Participants in this study performed two types of tasks: chest wall maneuvers and speech breathing activities. The chest wall tasks consisted of many different maneuvers, including isovolume, vital capacity, rib cage capacity, abdominal capacity, and relaxation maneuvers. Isovolume maneuvers were conducted, in which the participant displaced volume back and forth from the abdomen to the rib cage with a closed larynx. In vital capacity maneuvers, the participant inspired maximally from resting expiratory level then expired maximally. The minimum and maximum rib cage volumes during the vital capacity maneuver determined rib cage capacity maneuvers, and abdominal capacity maneuvers consisted of the range of abdominal volumes while the participant held their breath. Lastly, relaxation maneuvers were performed in which the participant completely relaxed the chest wall muscles while keeping their larynx closed. Speech breathing activities consisted of two measures: extemporaneous speech and reading speech. For the extemporaneous speech activity, the participant spoke 10 to 20 breath groups about the topic of his choice. For the reading speech activity, the participant read a 12-sentence

Sometimes when a patient is on the more common form of mechanical ventilation for an extended time or if the patient has undergone respiratory failure, their respiratory muscles have a tendency to become weak. With the use of this biphasic cuirass ventilation method they can have the opportunity to build and strengthen those muscles which, in return, can allow them to be weaned from the ventilator

From investigation in health practices, ventilator associated pneumonia caught my attention. “Ventilator Associated Pneumonia (VAP) is a leading cause of morbidity and mortality in intensive care units. Most episodes of VAP are thought to develop from the aspiration of oropharyngeal secretions containing potentially pathogenic organisms. Aspiration of gastric secretions may also contribute, though likely a lesser degree. Tracheal intubation interrupts the body’s anatomic and physiologic defenses against aspiration, making mechanical ventilation a major risk for Ventilator Associated Pneumonia. Semi-recumbent positioning of mechanically ventilated patients may help reduce the incidence of gastroesophageal reflux and lead to a decreased incidence of VAP. The one randomized trial to date of semi- recumbent positioning shows it to be an effective method of reducing VAP. Immobility in critically ill patients leads to atelectasis and decreased clearance of bronchopulmonary secretions. The accumulation of contaminated oropharyngeal secretions above the endotracheal tube cuff may contribute to the risk of aspiration. Removing these

Ventilator-associated pneumonia (VAP) remains a big drawback within the hospital setting, with terribly high morbidity, mortality, and cost. Some people tend to perform an evidence-based review of the literature that specializes in clinically relevant pharmacological and non-pharmacological interventions to prevent VAP. Thanks to the importance of this condition the implementation of preventive measures is predominant within the care of mechanically ventilated patients. There is proof that these measures decrease the incidence of VAP and improve outcomes within the intensive care unit. A multidisciplinary approach, continuing

As we breathe in, the muscles in the chest wall force the thoracic area, ribs and connective muscles to contract and expand the chest. The diaphragm is contracted and moves down as the area inside the chest increases as air enters the lungs. The lungs are forced open by this expansion and the pressure inside the lungs becomes enough that it pulls