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8/18/2019 Air Way & Ventilation
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BRHEATHING
(OXYGENATION & VENTILATION )for advance
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Objektf
• !e"a#a" anato" $%oo'ernafa%an
• a*at "ena "a%aa# *ernafa%an
• a*at "entataak%ana "a%aa#*ernafa%an
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+o"*onen *ernafa%an
en'at,ran Nafa% -• Vo,ntar. oe# otak be%ar• Invo,ntar. oe# Batan'
otak / on%• O0 c#e"ore%e*tor d a
carot%• 1O0 /H Rece*tor d
on%• Ek%*ra% oe# %trect#
re%e*tor d ar,
2.araf ernafa%an• a'fra'"a d%ara$ oe# n
*#rnc,% (ke,ar dar V 13415)
• ! ntreco%ta% d%ara$ oe#
*ercaban'an dar Vt#oraca dan V L,"ba
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+o"*onen ernafa%an
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+o"*onen ernafa%an
• e,ra vcera("ene"*e *ada*arenk" *ar,)
•
e,ra areta("ene"*e *adadndn' dada)
• Inter*e,ra %*ace
(r,an' nter*e,ra"e"k tekananne'atf)
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Bronc#,% 4aveo,%
•
6aan nafa%bercaban' 03ka .an'berak#r "enjad
377 j,ta aveo• 89 ercaban'an
*erta"a d%eb,tcond,ctn'
ar:a.
• 9 *ercaban'anterak#r d%eb,t
;ona *ernafa%an
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Aveo,%• -
• 2e e*te %ea*%**# < t.*e Iaveoar ce%=
• c,boda t.*e II
aveoar ce%>"e"*rod,k%%,rfactant=
• 2e t*e III ?the
free-ranging phagocytic alveolarmacrophage@
• +,ran' eb#
dda*at 577 to8777 *,"onar.
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Ga% Ec#an'e & ce Re%*ratonBa%c 2cence
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Ga% Ec#an'e & ce Re%*ratonBa%c 2cence
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T,j,an ernafa%an
• ert,karan GA2
–!e"a%,kan Ok%'en
–!en'e,arkan 1O0• en'at,ran A%a" Ba%a
• rotecton
• rod,k% %,ara
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rn%* *e"a%,kan ok%'en
• f,%=
• A*aka# df,%
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rn%* "e"a%,kan ok%'en
• f,% C *erbedaan tekanan
• Bera*aka# tekanan ok%'en *ada ,dara beba% –
ada ketn''an 7 "eter dar *er",kaan ar a,t>*ada %,#, 7D1 (30D)> Rata rata tekanan ,daraat"o%*#er F97 "" H'
– Ok%'en "er,*akan 08 ko"*onen ,dara jad
tekanan ok%'en 08 X F97 ""H' 85 ""H' – 2eta* kenakan 8777 ft (375 ") ketn''an>
tekanan baro"etrc t,r,n 05 "" H'> dan O0
t,r,n 5 "" H'
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f,% ok%'en *ada *ar,*ar,
Aveoar4Artera O.'en Gradent - (A4a)O0 8JF C (a1O0 8=05)K C a1
nor"a 85""H'= (akan teta* ta* *enn'katan ,%a 87 ta#,n Aa 'raden
akan nak J "" H#)
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ert,karan 1O0
• rnn%* - "n,te aveoar Venta%
• Aveoar venta% !n,te vo,"e CVo,"e tdAL
• AV (Tda vo,"e C ead %*ace) rek,en%
• ead %*ace 577 cc (oran' nor"a)
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Efek ead 2*ace *adaernafa%an
• Nor"a (Vt 577 cc)
(577 80 9 L/"n) C V2 (857 80 8=M
L/"n) VA (J=0 L/"n)
• en,r,nan (Vt 057 cc)
(057 J0 87>5 L/"n) C V2 (857 J0 9>3
L/"n) VA (J=0 L/"n)
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enaan ernafa%an
• A*aka# *enderta daa" keadaan'a'a nafa%
• A*aka# *ernafa%an *endertaadek,at
• A*aka# ada anca"an *ernafa%an*enderta
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A*aka# Ga'a Nafa%
• T*e 8 #.*ok%a (aO0 97 ""H')
• T*e 0 H.*ercarba (1O0 < 97""H')
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Tanda Ga'a Nafa% T*e I
• Ha% Laborator," - Ha% Bood Ga%Ana%a aO0 97 ""H'
• Ha% enaan aat %at,ra% - 2*a70 7
• +n% - – 2ano%% %entra - a70 97 ""H'
– 2ano%% erfer - a70 7 ""H'
– Ge%a#> a'ta%
– Acra dn'n1atatan - %aono%% tdak ter#at *ada *enderta den'an ane"aata,*,n %#ock
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A*aka# 2at,ra%
• 2at,ra% kear,tanok%'en daa" dara#
Ikatan HB47(7) %at,ra% OIkatan Hb4O(8) %at,ra% 05Ikatan Hb4O (0)
%at,ra% 57Ikatan Hb4O (3) 2at,ra% F5 Ikatan Hb4O(J) %at,ra% 877
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H,b,n'an aO0 den'an2at,ra%
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Aat 2at,ra% ok%'en
aa" "e"bacaaat %at,ra%*a%tkan
'eo"ban'%at,ra%> ba',%=rate ka*er %a"aden'an frek,en%
jant,n'
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+e%aa#an baca %at,ra%ok%'en
• a%e #'# readn'
– Ane"a
– 1.ano#e"o'obn
– 1.anda ntok%ka%
• a%e o: readn' – 2#ock
– H*o*erf,%
– Arteroveno,% 'raft
–H*oter"
– !en'',nakan va%o*re%or
– ,ore%cent '#t>
– cat k,k,
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en.ebab Ga'a nafa% T*e I
• +etn''an ek%tre"
• Gan'',an df,% *ar,
•
R'#t to eft %#,nt
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Tanda Ga'a Nafa% T*e II
• Ha% Lab Bood Ga% ana%a a1O0 <97 ""H'
• 1a*no'ra*#
• +n% – H.*o venta%
– 2o"noence
– !o%% *,*
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1ANOGRAH
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1a*no'ra*# 1,rve
#a%e 8 - 1O0 bera%adar dead %*ace#a%e 0 - 1O0 bera%adar ta"ba#an 'a%aveoar
#a%e 3 -1O0 ",rnbera%a dar aveo#a%e O - adaa#*en,r,nan 1O0 akbatn%*ra%ET1O0 - na ak#r
*ata, %e%aat %ebe,"n*ra%ET1O0 aO0 ( 3""H')
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Gradent ET1O0 dan aO0
• P","n.a 3 "" H'
• !enn'kat *ada keadaan – !enn'katn.a dead %*ace
– V/Q "%"atc#>
– %#,ntn'
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en.ebab 'a'a nafa% t*e 0
• enekanan *,%at nafa% (tra,"a ke*aa>%troke> t,"or)
• ,t,%n.a nerva% %araf *ernafa%an (f
cervca)• +ee"a#an otot ("%tena 'rav%> #*okae">
GB2)
• +eanan ron''a dada (%ko%%> k*o%%)
• H*erter"• en.akt *ar, kron% (1O)
• e"beran Bcarbonate
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Tanda ernafa%an tdakadek,at
• Laj, *ernafa%an – Brad.*ne M
– Tac#.*ea < 05
•ork of br#eat#n' – Nor"a - n%*ra% < "= da'fra'"a aktf
otot bant, nafa% - nterco%ta%>
%ternocedo"a%tod> rect,% abdo"en
Ek%*ra% < *a%f *ro%e% (jka adatanda
aktfa% otot nafa% tanda adan.a
ob%tr,k% jaan nafa%)
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Tanda ernafa%an tdakadek,at
• T*e Nafa% – 1.ne %toke%
– +,%"a,
– Bot
– H*erventa%
– A'ona
– 2#ao: – a*nea
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enderta den'an anca"an
ernafa%an
• ro:nn'
• +ebakaran daa" r,an' tert,t,*
•
!en'#r,* 1o0/1O
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Tataak%ana
• Ok%'en
• Venta%
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Ok%'en
• Aat ok%'en terba' – ed o.'en devce
– Non ed o.'en devce
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ed o.'en devce /Vent,r "a%k
!e"berkan kon%entra%ok%'en .an' teta*2an'at ber',na *ada*enderta den'an 1O
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Non ed O'en evce
+on%entra% ok%'en .an' dberkantdak %ea, %a"a
• Na%a can,e
• 2"*e ace !a%k• Non rebreat#en' !a%k
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+on%entra% ok%'en
Oksigen Device Flow Konsentrasi
Na%a 1an,e 849 L/" 0J C JJ
2"*e ace !a%k 9487 L/" J7497
NRB! < 87 L/" 7 C 877
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Venta%
• 6ack%on Ree%e
• Ba' Ventaton !a%k
• Ventator
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Ba' Vave !a%k Ventaton
Mask Ba'an .an' "ene*e *ada :aja#*enderta> #ar,% "ene"*e erat,nt,k "enja"n "a%,kn.a ,dara.an' dberkanFilters
+era* ka $ter d*a%an' antara"a%k dan ba' ("ence'a#konta"na% bakter *ada aat)Pressure relief valvesA *re%%,re reef vave (oftenkno:n a% a S*o*4,* vaveS) ,nt,k
"e"berkan bata%an tekanan.an' boe# dberkanBag Terdr dar bebera*a vo,"e(ter'ant,n' dar *e"b,at)Kantung Reservoar
!en."*an ok%'en
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