Talk:Mechanical ventilation

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Contents 1 Old, unsectioned comments 2 Cof-flator 3 Mechanical vs. hand ventilation 4 Requested move 4.1 Survey 4.2 Discussion 5 Spam or not? 6 Mechanical vs artificial 7 Initial ventilator and patient settings 8 Alternative modes of Ventilation 9 External links 10 Additional Tasks 11 Ventilator-associated lung injury

[edit] Old, unsectioned comments

victims can no longer breathe easily or cough to clear their lungs of dangerous mucus. Typically, these patients get a tracheotomy - a tube inserted through a hole drilled in the throat so air can be pumped in and secretions suctioned out. The opening is vulnerable to lethal bacteria and patients routinely get pneumonia. Often, they can't speak. Constant care to keep the tubes open forces many into nursing homes.

There is a noninvasive alternative that few doctors offer, contends Dr. John Bach of the University of Medicine and Dentistry of New Jersey. The key is a 1952 machine called the Cof-flator that, when held to the mouth, sucks air from the bronchial tubes to induce a cough that patients can't force unaided.

Once patients can clear their lungs, they can breathe with standard oxygen masks or with an easily learned inhaling technique

I wonder where this can be inserted into this article...
~ender 2003-09-10 02:11:MST

[edit] Cof-flator

Sucking air out of the lungs can cause lung collapse. A device called the Hayek RTX which has a secretion clearance mode has been shown to be at least if not more effective, without any of the problems of the cof-later, an old out dated technology. —Preceding unsigned comment added by 217.34.149.45 (talk) 11:16, 12 September 2007 (UTC)

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removed from article: This process usually also stabilizes patients' heart rhythyms, so in many cases, a ventilator is sufficient to keep a patient with a severely damaged body alive. This is, at least, very vague. Perhaps this sentence refers to the life-saving properties of ventilation in severe hypoxemic states? Anyway, needs to be clarified before it can go into the introduction. Kosebamse 07:57, 9 Oct 2003 (UTC)

[edit] Mechanical vs. hand ventilation

Have just put a wee bit about Vesalius and his method of inflating (animal lungs) in the history. On re-reading I feel that the history is focused on the mechanical aspects (i.e. machine-based) rather than the ventilation bit. I was going to add a bit about Lassen's work in Copenhagen during the polio epidemic which involved intubating patients due to the lack of iron lungs. Do people think this would be appropriate here? Anyone bothered if I re-jig the history bit to add a bit on manual (as opposed to mechanical) ventilation?Mmoneypenny 18:22, 16 September 2006 (UTC)

On second thoughts, what about renaming this page "Artificial ventilation" because that's what being described and the term encompasses manual and mechanical ventilation. What do YOU think? Yeah, you, with the blue eyes, glasses...Mmoneypenny 18:45, 16 September 2006 (UTC)

[edit] Requested move

[edit] Spam or not?

Upon brief inspection, I'm not sure this link [1] that was removed citing spam qualifies as spam. Opinions, anyone? Random wiki denizen from 24.166.2.5 21:45, 29 Dec 2006 (UTC)

It may be a useful link however it was added as part of a batch anonymously and without edit summaries by an IP address belonging to the publisher (see User talk:12.40.112.190). That sort of campaign-linking by the company itself is always inappropriate per the Conflict of Interest Guideline (and perhaps some other policies or guidelines as well). I did not remove that particular link however the editor that did was following the standard procedure for cleaning up after a linking campaign.

The appropriate step for someone with a conflict of interest is to suggest edits or links on the talk page and then let others decide.

If you want to to keep the link, by all means do so. --A. B. ^(talk) 23:12, 29 December 2006 (UTC)

Oh, I see. I was unaware it was added by the publisher. Thank you for clarifying that.24.166.2.5 03:35, 30 December 2006 (UTC)

[edit] Mechanical vs artificial

IMO, mechanical refers to the use of electrical, automated machines to provide assistance to breathing, whereas artificial ventilation is an umbrella term that includes both mechanical as well as hand-assisted ventilation. At least in the emedicine.com website listed at the end, mechanical ventilation does not include hand-assisted ventilation. Hand assisted, CPAP, BIPAP are categorized as noninvasive ventilation while mechanical ventilation refers to invasive ventilation requiring an ET or trach tubes.

And in addition, I don't think hand ventilation is mechanical at all in any sense Andrewr47 01:21, 11 January 2007 (UTC)

[edit] Initial ventilator and patient settings

This heading, IMHO, may lead to a description of how ventilators are set in any contributors own ICU, and also addresses more controversial issues of management a little too early in the article. At the moment, the article has a definate slant to adult ICU, and the comment about Assist control being the primary setting on a ventilator is certainly not true for many neonatal intensive care units, transport services (where the servos required fo AC ventilators may be too heavy and unweildy) and even those in countries with less wealth (these ventilators are up to 10 times the price of IMV). The article may be more informative if the heading modes of ventilation were to include AC ventilation, with a comment about its common use in adult ICU, rather than under this heading. would ventilator settings (as this is a more technical and controversial aspect of mechanical ventilation) be better towards the end of the article? Whyso 14:57, 11 February 2007 (UTC)

Agree with adult slant point. Removed following from HFOV description: "Mean airway pressure in HFOV is most often significantly higher than pressures provided with conventional PEEP (30-40 cmH2O or higher) and is usually started at ~10 cmH2O above the MAP measured during conventional ventilation." In infants the MAP is generally set at 1-2 cmH2O higher than with conventional. If comment is correct for adults, replace with qualification. Hallbrianh 19:53, 14 March 2007 (UTC)

[edit] Alternative modes of Ventilation

can this be changed to simply 'modes of ventilation'? I do not feel confident to counter the coment IMV 'is rarely used', but wonder if our anaesthetic colleagues would comment - I was under the impression it was commonly used for anaesthesia in which muscle relaxation was required (ie it was used on many thousands of people on a daily basis).Whyso 15:12, 11 February 2007 (UTC)

You are correct that CMV is frequently used in anesthesia. I added this comment. Have been looking at this entire page for a while. The page needed significant reorganization as it had an almost single focus on assist control use in adults from a somewhat one-sided point of view, together with a hodge podge listing of other modes without unifying explanation. Attempted to reorganize into more logical order and balance out presentation of modes and treatment decisions. Would welcome other suggestions. Still need to add references to much of this. 69.250.107.161 23:56, 14 March 2007 (UTC) Somehow signed out while I was making changes. They are mine. Hallbrianh 00:00, 15 March 2007 (UTC)

Thankyou very much - I have only had a quick look at the changes, but really like the logical progression of ideas - thankyou very much for making the changes Whyso 03:14, 18 March 2007 (UTC)

[edit] External links

External links on Wikipedia are supposed to be "encyclopedic in nature" and useful to a worldwide audience. Please read the external links policy (and perhaps the specific rules for medicine-related articles) before adding more external links.

The following kinds of links are inappropriate:

• Online discussion groups or chat forums
• Personal webpages and blogs
• Multiple links to the same website
• Fundraising events or groups
• Websites that are recruiting for clinical trials
• Websites that are selling things (e.g., books or memberships)

I realize that some links are helpful to certain users, but they still do not comply with Wikipedia policy, and therefore must not be included in the article. WhatamIdoing (talk) 07:00, 17 January 2008 (UTC)

[edit] Additional Tasks

Other sections needed for this article, in my view, include discussions of: 1. Ventilator triggering 2. Minute ventilation 3. ETT sizing and technique of placement 4. Flow loops and flow patterns 5. I:E ratio 6. Sedation and other medications, including nitric oxide 7. Oxygen delivery 8. Barotrauma Hallbrianh (talk) 18:49, 18 March 2008 (UTC)

[edit] Ventilator-associated lung injury

I think it is time to create an article or a section called ventilator-associated complications. There is already a separate ventilator-associated lung injury article. Nephron  T|C 06:42, 3 April 2008 (UTC)