Oscillators

  1. 0 Can someone please explain to me how oscillators work vs. the conventional ventilator? I have seen this and some of the RT's have explained it to me a few times but I am so confused. Hopefully the more times i do see oscillators, the more it will start to make sense to me.:uhoh21:
  2. Visit  bayouchick02 profile page

    About bayouchick02

    31 Years Old; Joined Nov '07; Posts: 109; Likes: 16.

    15 Comments so far...

  3. Visit  prmenrs profile page
    0
    See if this helps: https://content.nejm.org/cgi/content/full/347/9/633.

    Also, check in Merenstein and Gardner, chapter 23, p 616.
  4. Visit  PageRespiratory! profile page
    1
    Quote from bayouchick02
    Can someone please explain to me how oscillators work vs. the conventional ventilator? I have seen this and some of the RT's have explained it to me a few times but I am so confused. Hopefully the more times i do see oscillators, the more it will start to make sense to me.:uhoh21:
    >
    That is most certainly the million dollar question! Think tiny volumes (1-3 ml/Kilo*) and really high RR. The Vt is usually less then Pt's physiologic dead space, and is set by the MAP (mean AW pressure) and Pip. Exactly how adequate oxygenation and ventilation is achieved is somewhat of a mystery to me, I've read a bit about the subject and the general concencus is the occurance of coaxial flow (resonant frequency). I've seen a rate as high as 15Hz (900 bpm!) While exhalation is passive in the healthy lung (as well as conventional mechanical ventilation) the diaphram on an oscillator will not only deliver the desired volume, it will actively pull it out as well. HFV is part of a PLS (protective lung strategy) because we're dealing with such tiny volumes, we can ventilate with much lower pressures. Check out the following link for a much more detailed description than I'm able to offer.
    http://www.chestjournal.org/cgi/content/full/118/3/795

    *Egans Fundamentals of Respiratory Care 8th edition.
    bayouchick02 likes this.
  5. Visit  desilu92 profile page
    1
    I don't understand them completely but an RT offered this same type of info which I found on www.neonatology.org.

    "Unlike traditional ventilators, which essentially inflate and deflate the baby's lungs like a set of billows, the oscillator keeps the lungs open with a constant positive end-expiratiory pressure ("PEEP") and vibrates the air at a very high rate (up to 600 times per second). The vibration helps gases to quickly diffuse in and out of the baby's airways without the need for the "bellows" action which may damage delicate lung structures. Although oscillators are not appropriate for every disorder and situation, there is no doubt that because of their incredible power, oscillators have made it easeir to care for the very sickest babies with certain types of lung problems."
    bayouchick02 likes this.
  6. Visit  prmenrs profile page
    1
    The name of the game is to prevent barotrauma. Hence the increased use of non-invasive ventilation in recent years.

    But oscillators were great. Only problem was when the cardiologists come around to do heart ECHOs. One of those wierd heart docs actually asked me to take the baby off the vent b/c he couldn't get decent pictures. Um, no thanks, no CPR today, doc!
    HappyPediRN likes this.
  7. Visit  Ventjock profile page
    0
    Quote from prmenrs
    The name of the game is to prevent barotrauma. Hence the increased use of non-invasive ventilation in recent years.

    But oscillators were great. Only problem was when the cardiologists come around to do heart ECHOs. One of those wierd heart docs actually asked me to take the baby off the vent b/c he couldn't get decent pictures. Um, no thanks, no CPR today, doc!
    couldn't you just bag the kiddo REALLY REALLY FAST with super TINY breaths? :chuckle
  8. Visit  elizabells profile page
    0
    Quote from prmenrs

    But oscillators were great. Only problem was when the cardiologists come around to do heart ECHOs. One of those wierd heart docs actually asked me to take the baby off the vent b/c he couldn't get decent pictures. Um, no thanks, no CPR today, doc!
    Our XRay techs do this too! I'm always unable to explain why this would be a BAD idea because I'm so baffled by the idiocy of the request that I can't speak properly.
  9. Visit  prmenrs profile page
    0
    I forgot to mention that the child was PARALYZED. :angryfire

    "..couldn't you just bag the kiddo REALLY REALLY FAST with super TINY breaths?.."

    Sorry! NO. :wink2:
  10. Visit  PageRespiratory! profile page
    0
    Quote from prmenrs
    The name of the game is to prevent barotrauma. Hence the increased use of non-invasive ventilation in recent years.
    >
    I know this is off topic, but how does the use of NIPPV prevent barotrauma?
  11. Visit  elizabells profile page
    0
    Nevermind, I'm an idiot. NIPPV does not = the oscillator.
    Last edit by elizabells on May 5, '08
  12. Visit  SteveNNP profile page
    0
    Quote from PageRespiratory!
    >
    I know this is off topic, but how does the use of NIPPV prevent barotrauma?
    It doesn't. As long as you have a machine pumping gas in to achieve a set PIP/PEEP, you have the potential for barotrauma. The only advantage is that you can preserve the mucociliary protective barrier in the trachea by not having a ETT.

    NCPAP, on the other hand, only keeps the lungs open with a peep of 5, usually. The baby's lungs and respiratory effort determine PIP.
  13. Visit  prmenrs profile page
    0
    That's exactly it.
  14. Visit  Sweeper933 profile page
    0
    Quote from elizabells
    Our XRay techs do this too! I'm always unable to explain why this would be a BAD idea because I'm so baffled by the idiocy of the request that I can't speak properly.
    Seriously...
    Can't you see that this baby is as sick as they get...??? I guess the oscillator, more lines and drips then ever thought possible, and blood products running in just scream "move me all around just for the fun of it!"

    I can't believe the looks some of our x-ray techs will give me when I tell them "no, I'm not turing their head to face completely supine"


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