Artificial Organs - Lung: Boyle-Mariotte Law and Hyperbaric Oxygenation

Decompression Illness

• Therapy for decompression illness caused by too fast decompression after exposure to increased pressure is hyperbaric oxygenation (HBO)
• Gas bubbles in decompression illness can cause pulmonary embolism

Pulmonary Embolism

• Recommended therapy for pulmonary embolism is hyperbaric oxygenation (HBO)

Mechanical Ventilation

• Goal of mechanical ventilation is to provide a work of breathing for the patient
• Mode of ventilation that depends on lung compliance is Pressure-Regulated Volume Control (PRVC)

History of Ventilation

• According to John Hunter in the mid-18th century, the first method-of-choice after drowning was mouth-to-mouth respiration
• In the early 1800s, the first device described as a negative-pressure ventilator was the "spirometer"
• Drinker and Shaw modified the device in the 1920s, leading to the invention of the 'Iron Lung'

Non-Invasive Ventilation (NIV)

• Mode most commonly used for prolonged weaning and spontaneous breathing trials is Pressure Support (PS)
• SIMV in NIV stands for Synchronized Intermittent Mandatory Ventilation
• Primary goal of Pressure-Regulated Volume Control (PRVC) in NIV is to provide a work of breathing for the patient
• Mode that adjusts peak inspiratory pressure (PIP) constantly in relation to the goal tidal volume is Pressure-Regulated Volume Control (PRVC)
• Mode associated with increasing residual volume and hyperventilation as potential complications is Volume-Control (VC)
• Popular mode for Acute Respiratory Distress Syndrome (ARDS) is Pressure-Control (PC)
• Mode that aims to provide a work of breathing for the patient is Pressure Support (PS)
• Mode that utilizes varying pressures depending on pulmonary compliance and airway resistance is Pressure-Regulated Volume Control (PRVC)
• Primary complication associated with Pressure Support (PS) mode is over-assistance
• Mode characterized by breaths that are patient- or time-triggered and are pressure-targeted and time-cycled is Pressure-Control (PC)
• Mode that adjusts peak inspiratory pressure (PIP) according to the goal tidal volume and is commonly used for Acute Respiratory Distress Syndrome (ARDS) is Pressure-Control (PC)
• Mode that allows spontaneous breaths to be unsupported and slightly pressure-supported is Pressure Support (PS)
• Main indication for using a nasal cannula for NIV is for patients with claustrophobia or facial trauma
• Contraindication for NIV using a mask is facial trauma or severe maxillofacial disease
• Indication for continuous positive airway pressure (CPAP) is for obstructive sleep apnea
• Bi-level Positive Airway Pressure (BPAP) helps to reduce pressure during exhalation
• Main indication for hyperbaric oxygenation (HBO) is for decompression illness
• Oxygen Dissociation Curve illustrates the relationship between PaO2 and SaO2
• If SaO2 is 97% and SvO2 is 65%, the Sa-vO2 value is 32%
• Mode of NIV with a low risk of ventilation-related injuries or pneumonia is CPAP
• Condition that would indicate the use of a nasal cannula is claustrophobia or facial trauma
• Condition that indicates the use of Bi-level Positive Airway Pressure (BPAP) is chronic obstructive pulmonary disease (COPD)
• Most common contraindication for NIV using a mask is facial trauma or severe maxillofacial disease
• Continuous Positive Airway Pressure (CPAP) helps to open up atelectatic regions in the lungs