(BQ) Part 2 book “Principles and practice of mechanical ventilation” has contents: Physiologic effect of mechanical ventilation, artificial airways and management, complications in ventilator-supported patients, management of ventilatorsupported patients, and other contents. | IX PHYSIOLOGIC EFFECT OF MECHANICAL VENTILATION This page intentionally left blank EFFECTS OF MECHANICAL VENTILATION ON CONTROL OF BREATHING 35 Dimitris Georgopoulos PHYSIOLOGY EFFECTS OF MECHANICAL VENTILATION ON FEEDBACK SYSTEMS Chemical Feedback Response of Respiratory Motor Output to Chemical Stimuli Operation of Chemical Feedback Neuromechanical Feedback Neuromechanical Inhibition Behavioral Feedback The main reasons for instituting mechanical ventilation are to decrease the work of breathing, support gas exchange, and buy time for other interventions to reverse the cause of respiratory Mechanical ventilation can be applied in patients who are making or not making respiratory efforts, whereby assisted or controlled modes of support are used, In patients without respiratory efforts, the respiratory system represents a passive structure, and thus the ventilator is the only system that controls breathing. During assisted modes of ventilator support, the patient’s system of control of breathing is under the influence of the ventilator –4 In the latter instance, ventilatory output is the final expression of the interaction between the ventilator and the patient’s system of control of breathing. Thus, physicians who deal with ventilated patients should know the effects of mechanical ventilation on control of breathing, as well as their interaction. Ignorance of these issues may prevent the ventilator from achieving its goals and also lead to significant patient harm. PHYSIOLOGY The respiratory control system consists of a motor arm, which executes the act of breathing, a control center located in the medulla, and a number of mechanisms that convey information to the control Based on information, the control center activates spinal motor neurons that INTERACTIVE EFFECTS OF PATIENT-RELATED FACTORS AND VENTILATOR ON CONTROL OF BREATHING Mechanics of Respiratory System Characteristics of Muscle Pressure .
