Principles of sleep ventilator therapy
The ventilator delivers pressurized, filtered, warmed and humidified air to the patient. After the pressurized air enters the respiratory tract, the patient's lung tissue still has more air volume (ie, functional residual capacity) even at the end of expiration. The existence of this part of the air volume will stimulate the upper airway tissue, increase the upper airway muscle tension, and prevent the upper airway from collapsing during sleep, so that the upper airway can be kept open enough during sleep and wakefulness to avoid cycles during sleep. Sexual airway collapse. Thereby reducing the airway resistance of the upper airway and eliminating airway obstruction.
* The principle of sleep ventilator treatment
* Working principle of sleep ventilator
sleep ventilator therapy
Nasal Continuous Positive Airway Pressure ( Continous Positive Airway Pressure ) : CPAP is the preferred method for the treatment of sleep - disordered breathing. Especially for moderate to severe patients or patients with hypercapnic respiratory failure. The use of CPAP ventilator therapy has the advantages of non-invasive, efficient, convenient, and long-term treatment at home. It can also be used before and after surgical treatment, when lifestyle changes, focusing on weight loss, rest, exercise and other measures have not achieved the desired effect.
*As shown in the figure above, the core principle of CPAP treatment is to raise the pressure level of the patient's breathing, so that the patient's respiratory airway is always at a positive pressure level, so that the upper airway is permanently expanded, avoiding the upper airway caused by negative pressure during the inspiratory phase. Obstruction and suffocation
Automatic adjustment of positive airway pressure (auto-CPAP) : Compared with CPAP therapy, the biggest advantage of auto-CPAP therapy is that the positive pressure provided by the ventilator is automatically adjusted. Traditional CPAP therapy, which provides positive pressure, requires manual CPAP titration of pressure by using polysomnography on the patient overnight. The Auto-CPAP ventilator can automatically complete the pressure titration according to the obstruction and suffocation of the patient during sleep to determine the positive airway pressure required by the patient. Compared with CPAP, auto-CPAP can significantly improve the comfort of patients with sleep breathing ventilation, and at the same time greatly monitor and facilitate patient treatment.
Horizontal positive pressure ventilation (Bi-PAP) : Bi-PAP is developed on the basis of CPAP. It can adjust different inspiratory and expiratory pressures, so that the upper airway has two positive pressure levels, high and low, that is, higher Inspiratory pressure at the pressure level produces additional expiratory volume; expiratory pressure at a lower positive pressure level keeps the airway widened and open. Compared with CPAP, Bi-PAP ventilator has the following advantages: (1) better synchronization performance, patients are more acceptable than CPAP treatment, patients feel comfortable, and show better compliance; (2) the average nighttime pressure level is compared The CPAP ventilator is significantly reduced, and the lower expiratory pressure level can reduce the work of breathing, making the patient's breathing more comfortable and natural, and producing a better therapeutic effect; (3) S/T and S/TD breathing based on BiPAP basic mode mode, which can better treat patients with central sleep-disordered breathing.
* By switching between high and low pressure levels, it not only ensures the patency of the airway, but also provides sufficient inspiratory support, thereby eliminating the excess work of breathing caused by the higher end-expiratory pressure.
Adaptive Servo V entilation : ASV is a new approach to the treatment of central sleep apnea or Cheyne-Stokes respiration . Its working principle is to provide a baseline ventilatory support pressure (about 4 cmH2O), and automatically adjust the pressure level to maintain 90% of the predicted average ventilation through continuous measurement of the ventilation volume of each breath. Compared with CPAP, ASV is more reliable in the long-term treatment of complex sleep apnea.
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