Multiprofessional Critical Care Review: Adult (2023)-1: Mechanical Ventilation I: Principles of Mechanical Ventilation (Khalilah L. Gates, MD)

Video Transcription

Video Summary

In this lecture, Dr. Kalila Gates discusses the principles of mechanical ventilation and the design features and mechanics of common ventilators. She emphasizes the importance of understanding the terminology used in mechanical ventilation and proposes a framework that describes breaths using three components: the trigger, the target, and the cycle. The trigger refers to what initiates the breath, the target governs the gas flow to deliver the breath, and the cycle determines how the breath is stopped. Dr. Gates also discusses the different modes of mechanical ventilation, including volume control, pressure control, and pressure support ventilation. She explains how each mode is characterized by its own combination of trigger, target, and cycle. Dr. Gates also introduces the concepts of transpulmonary pressure and alveolar stretch as important factors to consider in mechanical ventilation. She explains that stress, or transpulmonary pressure, is the force applied to the lung, while strain, or alveolar stretch, is the deformation of the lung under stress. Dr. Gates emphasizes the need to minimize transpulmonary pressures and alveolar stretch to prevent ventilator-induced lung injury. She concludes her lecture by discussing the effects of positive pressure ventilation and providing examples for fine-tuning ventilator settings based on compliance, driving pressure, and pressure-volume relationships.

Keywords

mechanical ventilation

ventilators

terminology

trigger

target

cycle

modes

transpulmonary pressure

alveolar stretch

lung injury

ventilator settings

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