Non-Invasive Positive Pressure Ventilator (NPPV)

The VAP Prevention Protocol is intended primarily for the following healthcare professionals: • Respiratory Therapist • Nurses • Physicians • Physician Assistants • Anesthesia Technologist STATEMENT OF PURPOSE • To eliminate ventilator associated pneumonia in adult patients in an intensive care unit. • To encourage physicians, ICU nurses, and respiratory therapist to use the ventilator associated pneumonia bundle in all ventilated patients in an intensive care unit.

WHAT IS APRV? Airway pressure release ventilation (APRV) is a fairly new mode of ventilation, just becoming available in the U.S. in the mid-1990’s. APRV is “inverse ratio, pressure controlled, intermittent mandatory ventilation with unrestricted spontaneous breathing and it is based on the principle of open lung approach”. (Daoud, Farag, & Chatburn, 2012) The open lung approach is “concept of maximizing and maintaining alveolar recruitment throughout the ventilatory cycle by potentially ventilating the lung on the steep portion of the pressure-volume curve, thus avoiding over-distention on inspiration and alveolar collapse on exhalation”. (2012) APRV “was first used and described in 1987 as CPAP with an intermittent pressure release phase. Continuous airway pressure is applied to maintain adequate lung volume and improve alveolar recruitment. It is a pressure-limited, time-cycled, volume-variable mode of ventilation.” (2012)

Negative pressure ventilation relies on the ability to move the chest wall. Negative pressure ventilation (NPV) has also been used in treatment in CCHS patients, however it has been linked to upper airway obstruction during sleeping. Nasal mask ventilation has also been proven in children who are older than 7 years of age with a dependency on nocturnal ventilation. This is the preferred mode of ventilatory support by parents and patients.[32]

Home mechanical ventilation (HMV) has been used as long-term ventilation for over 70 years to manage chronic ventilatory failure. In the United States, the first introduce of mechanical ventilation was by the use of the iron lung which used with polio victims (Tobin, 2006). Iron lung was the only way available that time to ventilate Poliomyelitis patients and injured army soldiers (Goldberg, 2002).In 1950s, the use of intermittent positive-pressure ventilation with mouth piece have began ,and in 1952, the use of intermittent positive-pressure ventilation (SIMV) via tracheostomy was introduced (Tobin, 2006). In France, professor Rideau had tried applying another method of mechanical ventilation for some of his patients who were suffering

Running head: VENTILATOR-ASSOCIATED PNEUMONIA Ventilator-Associated Pneumonia (VAP): The Key to Prevention Aleisha N. Curry Professional Role Development II Nursing 402 Christian Brothers University February 20, 2012 Sue Trzynka, Ph.D., RN Introduction In the fast paced Trauma Intensive Care Unit (TICU) there are many things to remember while working with ventilated patients. Therefore, it

considered a relative contra- indication due to risk of aspiration pneumonia and mischance ventilation. According to international guidelines the conventional invasive mechanical ventilation (IPPV) is the best option for patients with impaired conscious state. 5 As IPPV is associated with many complications and difficulty in weaning in COPD patients .

#1 Change The Water Filter One of the most important components of your humidifier is the water filter. Water has to flow through the filter in order for your humidifier to create the right level of humidity for your house. When the humidity level is too high in your house, your humidifier will pull moisture out of the air and pass it through the water filter.

• Maintain humidity in your home by using less air conditioning or by using a humidifier.

Introduction: As a student completing senior synthesis in the pediatric intensive care unit, I see many patients, both chronic and acute, that require mechanical ventilation. I understand the many risks involved with this life-saving procedure, but at the same time I often question why the patient must remain on the ventilator

Therefore, PC can be considered a component of protective strategies for lungs.3 As several studies have shown that limiting the peak pressure spares more normal areas of the lungs from overinflating. During pressure control ventilation change in lungs characteristic such as compliance and airway resistance would cause changes in volume and flow.1-3 However, this is opposite during volume control ventilation. Consequently, change in lung characteristics would cause changes in pressure. For instance, increasing airway resistance will increase the amount of pressure require to deliver the volume, thus increasing the peak airway pressure. The major disadvantage of PC is that the tidal volume and minute ventilation or volume per minute (VE) reduces when lungs characteristics

Figure 11 - Building humidification. The air humidification process operates as follows. 1. Outdoor air (OA) enters the system (Figure 11). 2. The air passes through dampers that maintain a mixed air setpoint (SP). The SP is The air passes through particulate filters and the heating and cooling coils. Flow through the coils is determined by TC-2 and sensed by TT-2.

MANAGERIAL ECONOMICS 407 1 ABSTRACT This project encompasses a managerial economical view of a durable medical equipment company (DME), that is located in Spokane Valley, Washington. Within the project is a background of information regarding the company and the products and structure that define the company. It continues with some special considerations regarding the economics

The article explained the important of intubated patient placed on ventilator because of the respiratory drive cannot initiate ventilatory activity because of disease or drugs. Also, explain the significant of removing patient from ventilator after showing the improvement. Unnecessary delay in withdrawing mechanical ventilation will increase the complication such as pneumonia, discomfort, and ventilator induced lung injury, and increases cost. It is necessary to check patient condition before removing from ventilator in order to avoid the risk of premature withdrawal, which include difficulty ventilator muscle fatigue, and compromised gas exchange. It is necessary to understand all the reasons the patient continues to require mechanical

As I was involved in the care of the patient I had to explain to the wife why her husband was connected to a ventilator and it use. A ventilator is an artificial breathing machine that moves oxygen-enriched air in and out of your lungs. If your lungs have failed and you cannot breathe on your own, you will need to be attached to a ventilator (See appendix 3).

The CPAP consists of a small ventilator, from a pipe and a nasal mask or nose buccal. Of course, all these elements are chosen and carefully calibrated, using a procedure defined titration, depending on the patient and the characteristics of his nocturnal respiratory pathology. The greater the attention given to the patient and the medical personnel's experience at this stage, the higher the patient treatment compatibility.