Famous Among Top Surgeons in the 90s
Chapter 1182: [1182] Doing your homework well is very important

Chapter 1182: [1182] Doing your homework well is very important

The explanation above is not entirely accurate. The reason lies in the distinction between invasive and non-invasive ventilators. Invasive ventilators are far more common in the ICU compared to other departments. Non-invasive ventilators are widely used in respiratory medicine, and there are typically more than just one or two in use.

Let me first explain what "invasive" and "non-invasive" mean. The key difference lies in the word "invasion," which implies trauma. Invasive ventilation and non-invasive ventilation correspond respectively to invasive mechanical ventilation and non-invasive mechanical ventilation.

Mechanical ventilation, to put it simply, refers to the connection between the machine and the patient. Invasive ventilation means the ventilator is connected to the patient through intubation. Non-invasive ventilation, on the other hand, connects the ventilator to the patient using equipment like masks that do not cause bodily harm.

Broadly defined, non-invasive ventilation is not limited to ventilators and also includes techniques like diaphragm pacing. However, the latter is rarely used clinically and is seldom seen. There’s generally only one reason why certain clinical technologies aren’t widely adopted: the cost of treatment does not align with its effectiveness.

Non-invasive ventilators see widespread use in respiratory medicine for the same reason—they are less expensive, relatively affordable for patients when compared to invasive ventilation, and yield good clinical outcomes. Administering non-invasive ventilation at a very early stage can reduce the likelihood of the patient’s condition deteriorating to the point where invasive ventilation is required.

Invasive ventilators can also be used for non-invasive ventilation. So in the ICU, you might observe cases where, after extubation, patients still require non-invasive ventilation, and the same invasive ventilator is repurposed for this. After all, the ICU is well-stocked with such ventilators. However, non-invasive ventilators cannot be converted into tools for invasive ventilation. Due to their lower cost, non-invasive ventilators are inherently limited, such as in compressor power and other parameters, and are far from meeting the requirements of invasive ventilation.

Ventilators are precious, especially invasive ones, and must be managed by dedicated personnel, typically assigned nurses. Routine tasks like disinfecting and maintaining ventilators are also performed by nurses.

Nurses trained in ventilator operation can adjust some basic parameters, but for critically ill patients, adjusting ventilators and modifying parameters is exclusively the doctor’s responsibility, as only doctors can interpret the various monitoring indicators of patients.

The skill of properly adjusting ventilator parameters can be said to be the expertise of doctors specializing in the study of human respiration.

This morning, with some spare time, the enthusiastic Teacher Xin Yanjun stood beside a ventilator to give a lecture to the new students. "Do you know what we base our adjustments to ventilator parameters on?"

"The most commonly used and most useful monitoring indicator should be the patient’s blood gas analysis," Xie Wanying replied.

Hearing her rapid answer, Xin Yanjun froze for a moment, surprised by the accuracy of her response. Ventilator management has always been a critical focus in internal medicine, and for a surgical student to come to respiratory medicine on their first day and provide such a correct answer was no small feat.

Xie Wanying’s answer didn’t sound like something purely learned from books—it reflected some level of clinical experience. Xin Yanjun began to suspect that she might have previously studied related knowledge somewhere in clinical practice.

Teacher Xin’s suspicion was indeed correct, though Xie Wanying could not easily admit it. She was reborn. In her past life, she had worked in the laboratory department, where ICU patients on ventilators regularly required blood gas analysis, often in urgent circumstances even in the middle of the night. Years of accumulated work experience had allowed her to understand ventilator monitoring indicators, sometimes even better than the average internal medicine doctor.

Laboratory work necessitates integration with clinical practice, and such tasks typically involve learning and research alongside clinical cases.

"The modes of ventilators may appear to be numerous, but in reality, the principles of ventilators are as follows. Initially, without sensors, the machine directly delivered air to the patient’s airway. With the advent of sensors, the machine could detect the patient’s breathing status and make appropriate adjustments, creating better coordination between the machine and the patient’s respiratory patterns. Adjustments can be made either via the machine’s computer system or manually by medical staff. This principle forms the basis for the various computer-controlled modes available nowadays."