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Respirator is a medical device that is alternatively called an artificial lung. Its task is to support or replace the patient's muscles necessary for breathing. Supporting breathing with a ventilator is possible both in the hospital and at home.

Respiratorforces the breathing process in people who, due to injury, disease or the use of neuromuscular blocking drugs, cannot breathe on their own - suffer from severe respiratory disorders. The machine is also used in situations where the patient is breathing alone, but the process is inadequate for some reason, i.e. when the body does not meet the body's oxygen requirements.

Respirator - the history of an artificial lung

Few people know that Leonardo da Vinci developed the first designs of respiratory devices in the 15th century. The first working respirator was the work of Jean-Francois, Pilatre de Rozier, which was created in the 1880s.

The first widely used respirator known as the "iron lung" was developed by Philip Drinker and Louis Shaw of Harvard University in Cambridge in 1928. The principle of the device was to generate negative pressure around the patient's chest.

The device looked like a large metal box closed with a hatch. The patient was placed inside - only the head protruded outside. The tightness of the apparatus was ensured by rubber gaskets adhering closely to the patient's neck.

By varying the pressure inside the unit with two household vacuum cleaners, the chest was forcibly lifted or squeezed, forcing air into the lungs and expelling it.

Respirator in hospital and at home

Until recently, ventilators, mainly due to their size, could only be used in hospitals, mainly in intensive care units. Currently, thanks to the progress of medicine and technology, respirator treatment can also be used in ambulances and at home.

Modern respirators may be compact, lightweight, and more reliable. In addition, medical procedures have been developed to enable the effective and safe use of mechanical ventilation outside the hospital for the patient. Modern devices still play the role of an artificial lungby forcing breathing work.

Both hospital and home ventilators are most often used in severely injured, unconscious or weakened patients, suffering from lung diseases, taking drugs that block neuromuscular conduction. The devices can have various amenities, e.g. the ability to set the desired oxygen content in the air that the patient breathes.

Respirator - the role of mechanical ventilation

Proper ventilation of the body, i.e. proper breathing, is crucial for the efficiency of all organs. The ventilator can be connected to the patient in two ways. The first method is invasive and involves connecting the ventilator tube to an artificially created opening leading to the trachea (tracheotomy).

The non-invasive connection consists in putting on various types of masks on the patient's face.

Invasive ventilation is usually carried out in hospitals, but it is also possible to bring the patient home so that the patient is in a friendly environment. But much more often at home, non-invasive ventilation is used.

Non-invasive ventilation is used in the form of sessions of mechanical ventilation combined with independent breathing of the patient.

The use of a respirator, i.e. mechanical ventilation, should last no less than 60-90 minutes. This is the time when the patient's respiratory muscles can regenerate. But the timing of ventilation is always dependent on the patient's condition. The more serious the patient's condition, the longer the ventilator should be used.

Respirator - what does the sick person gain

There are specific benefits to the use of a ventilator for the patient, regardless of whether ventilation is provided in the hospital or at home. The advantages of using a respirator can be divided into three groups.

artificial ventilation helps to reduce the symptoms of alveolar hypoventilation, i.e. to obtain better and deeper breathing, regenerate the respiratory muscles, more effectively expectorate (or remove) the secretions remaining in the respiratory tract, reduce the number of infections or their milder course, improve the comfort of life, increase life activity and sometimes also professional, even in the case of complete respiratory failure, patients may leave the hospital and return home Respirator - indications for use According to medical knowledge, the indications for using a ventilator (also at home) are:

neuromuscular diseases, e.g. myopathy, myopathy (Duchenn's, Becker's dystrophy) spinal muscular atrophy (SMA), amyotrophic lateral sclerosis (ALS) post-disease statesHeine-Medinastana after high (cervical) spinal cord injuries, diseases of the central nervous system, e.g. central nervous system hypoventilation syndrome (the so-called "Ondine's curse"), vascular damage, diseases of the chest wall, e.g., hyphoscoliosis (curvature of the spine) and other deformities of the chest, conditions after lung and chest surgery Chronic obstructive pulmonary disease (COPD) obese hypoventilation syndrome (Pickwick's syndrome) Other reasons that indicate the need to use a ventilator include:

  • pulmonary fibrosis
  • waiting for lung and heart transplant
  • Respiratory-disabling birth defect syndromes
  • palliative states
  • circulatory failure
  • cystic fibrosis
  • sleep apnea (of central origin, but also selected cases of obstructive apnea)
  • breathing disorders in severe COVID-19

Respirator - reimbursement

The use of a respirator at home, both for children and adults, is reimbursed by the National He alth Fund. The necessary condition for the use of the ventilator is that the patient has he alth insurance and a document confirming this fact.

Patients requiring ventilator therapy can be reported by their physicians, families, caregivers or in person.

Respirator - complications of mechanical ventilation

The major complication of mechanical ventilation is pneumonia. There is a 1% incidence in intensive care units, but when mechanical ventilation is used, the rate can be as much as 20 times higher.

In the case of using old-style respirators, it was observed that the main nebulizer was the habitat and source of Gram-negative bacteria that infected the patient's alveoli. Currently, the main risk factor is the tracheal tube.

Disorders in the circulatory system include:

  • abolition of the chest mechanism as a pump
  • heart tamponade
  • impaired blood supply to the lungs

Lung injuries are also observed among the observed complications, including:

  • pneumothorax
  • mediastinal pneumothorax
  • interstitial lung emphysema
  • acute lung injury caused by excessive bloating
  • Long-term mechanical ventilation has a negative impact on the functioning of the kidneys, the work of which is more disturbed the higher the pressures are used in mechanical ventilation.
About the authorAnna Jarosz A journalist who has been involved for over 40 yearsin popularizing he alth education. Winner of many competitions for journalists dealing with medicine and he alth. She received, among others The "Golden OTIS" Trust Award in the "Media and He alth" category, St. Kamil awarded on the occasion of the World Day of the Sick, twice the "Crystal Pen" in the national competition for journalists promoting he alth, and many awards and distinctions in competitions for the "Medical Journalist of the Year" organized by the Polish Association of Journalists for He alth.

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