An Introduction to Mechanical Ventilation (Mechanical Ventilation - Lecture 1)

A lecture on the indications for mechanical ventilation, as well as the physiologic differences between negative and positive pressure ventilation.

Use of the VA and Stanford name/logos is only to indicate my academic affiliation, and neither implies endorsement nor ownership of the included material.

[StrongMed]

Dr. Kim, I think the issue of aspiration in mechanical ventilation is something that medical science doesn't fully understand. Despite the ET tube seeming like it should completely seal off the trachea, most critical care docs believe that microaspiration still occurs around the tube's cuff. And while these microaspirations are small in volume, and thus with limited bacterial load, they can become clinical pneumonias due to absent cough and impaired mucocilliary clearance in sedated patients.

[darkygirl]

thank you for the lecture.. very useful ima emergency resident and always had difficulty with mechanical ventilation... thank you for making it simple :D watching the next lecture

[xoxo]

Thanks for the lecture, I am an RT first semester student trying to get ahead of my learning.

[sanmata]

we buy Plastic tubing (Or we use a nasal oxygen cannula) and make a double loop on the ET tube, then a loop on the OPA and then a simple knot on the side of the patient, and we put some gauze to protect the lips... excellent video Dr.Strong i found it very insightful and well´d explained.... sorry about my Mexican English

[Duxdex]

Hello your channel is one of the best channels on YouTube, I am a PGY2 in a small university program and I was thinking to apply to PCC but after watching your videos you inspired me to become an Internist and a Hospitalist

[DrHieu]

Thank you Eric's Medical Lectures . You are good teacher, so good.
I can't say what to thank you, you are really great teacher for me and others.
I'm working at NICU in Vietnam and these video is useful for me. I can understand about mechanical ventilation although baby is different adult.
Thank you, best wish for you and your familly.
Namo Amitabha!

[ring]

nice, bit of history thrown in, love it.

[StrongMed]

...although the trachea isn't sealed in negative pressure ventilation, patients are still awake, able to cough, and probably don't have the same degree of intrapulmonary immune dysfunction seen in intubated patients. Of course, since negative pressure is so rarely used now, and there's never been a head to head trial comparing aspiration risk, the answer to the question of which has higher aspiration risk will probably never be known for sure.

[nissnice]

Always a pleasure to learn from you dr strong

[turkizasmr]

Thank you so much its the first. Time i had totally understand the mechanical ventilation

[mrfoxcoder]

Sir, thanks for these valuable lectures they really helpful in understanding Ventilator .   Hope in future you will be uploading more of these, specially  on Advance Mode of Ventilators

A.David
Respiratory Therapist (STUDENT)
PGIMER, CHANDIGARH INDIA

[mdsolt]

Thank you so much for your great lectures. I watched them several times again and again. I'm an emergency medicine doctor in South Korea. I'd like to ask a question about one of the advantages of negative pr. vent. You mentioned 'probably lower risk of aspiration'. Is it the reason why most of the patients using iron lung are mentally alert? Actually, E-tube seals the trachea, therefore it protects airway, but iron lung has no way to protect airway. Isn't it the advantage of positive pr vent?

[julianncrowley]

Great series of lectures. I am studying Masters of Emergency Nursing in Australia and the series is great to assist with Advanced Ventilation.
 Can you complete a presentation on Paediatric Ventilation?

[aquaphone]

Fantastic lecture, thanks Dr Strong. BTW, taping the ET tube directly to the patient's face often works much better than using the specially designed straps. I've seen many injuries caused by the straps/devices, and far fewer injuries from the tape. That's just my experience as an ICU nurse, I realize it's not a peer reviewed study. But do reconsider using tape. :)

[sulsha]

1) What happens in people which do not have an effective elastic recoil..?

Applying Positive Pressure does it lead to retaining of air within alveolar sacs.. can it get accumulated over time.. or even lead to rupture of the sac..

How would we avoid it..?

2) at. 11.20, why is there an initial negative dip at the beginning of Inspiration..? Is it because of Sudden increase in volume of lung, thereby momentarily pressure dropping..

[drljs]

Sir, thanks for these  lectures! They were really helpful for me to understand Ventilation. I'm a Resident of  Internal medicine in South Korea catholic medical center, can I have the presentation files of your lecture :) ?

[sanmata]

Pre fabric tube holders, are more fancy, and definitively gives a more professional look, i use the Tomas ET tube holder when using it on the ambulance, its easy and fast to use, but... sometimes it allows the tube to be dislodged or pulled out of place, its seems to me it has something to do with abundant secretions or malfunction of the screw, and what we do in some cases..

[sanmata]

Hello, in my opinion, both ways are as effective as they can be dangerous, here in México, pre fabric devices are not common, the usual way its tape, and i think it depends on the way you use Both of them, in my experience as an EMT, and working shifts on the emergency room, and the ICU is that tape can cause serious injuries to the face, lips and neck, when it´s applied with too much pressure, also, depends on the way the tape its applied to fix the tube...

[aquaphone]

Hmmm.... come to think of it I have had family members complain about the appearance of the tape.. quite a few times....

BTW plenty of my colleagues feel the tube holders are superior. I guess it doesn't matter as long as the method is applied properly. I've had bad experiences with the devices, but then, I'm less familiar with them. Thanks again for the video :)

[Mazzawak]

6:41 why is there an octopus in the ventilator?