Artificial ventilation of the lungs is the hi-tech medical procedure which is capable to lead to growth of development of complications. Therefore methods of monitoring of patients which are on a respirator were developed for safety of artificial ventilation of the lungs. These methods are especially important in the conditions of a pandemic as mass arrival of patients can result in the shortage of medical personnel and, therefore, increase of risk of various complications. Especially it is important in those conditions when load of medical personnel is much higher than usual.
When carrying out artificial ventilation of the lungs different types of monitoring can be used. For example, such types of monitoring as a pulsoksimetriya, a kapnografiya, measurement of noninvasive arterial blood pressure, measurement of pulse rate, measurement of heart rate and also actually respiratory monitoring and measurement of indicators of gas composition of blood are widely used. The last type of monitoring usually includes registration by a respirator of special indicators, in particular, of the respiratory volume, minute ventilation, peak pressure in respiratory tracts, constant positive pressure at the end of an exhalation and other important parameters. Besides, in the course of carrying out artificial ventilation of the lungs existence of constant observation of the patient by means of medical personnel which allows to react to changes which will be registered by the control watching equipment or which will be clinically shown in due time is extremely important.
Pulsoksimetriya is the most available and one of the most informative methods of monitoring. Use of various pulsoksimetr as in itself, and as a part of monitors is capable to reveal quickly at the patient a hypoxia of various etiology. Such problems as depressurization of a contour, obturation of an endotracheal or tracheostomy tube a phlegm, tube shift in the right bronchial tube and many others come to light when using a pulsoksimetriya at once that allows to react and solve a problem quickly. In combination with other types of monitoring the pulsoksimetriya is capable to diagnose other morbid conditions quickly. The method is rather inexpensive and finds very broad application in a modern intensive care.
Use of a pulsoksimetriya when carrying out an intubation of a trachea as it allows to reveal in due time development of a hypoxia is very important and to correct actions of the doctor. It is especially important in the context of a koronavirusny infection as most of patients by the time of an intubation have a hypoxia of this or that degree of manifestation.
Kapnografiya, unlike a pulsoksimetriya, is monitoring not of oxygenation, and ventilation of the patient. This way is very widely used for verification of the provision endotracheal or tracheotomic tubes and also for determination of adequacy of ventilation. Kapnografiya helps to establish in due time the wrong provision of an endotracheal or trekheostomichesky tube, to register restoration of neuromuscular conductivity, a spontaneous physical activity at the patient and also indirectly reflects a condition of a hemodynamics and metabolism.
When carrying out monitoring of the patient with IVL indicators of respiratory mechanics are extremely important. Usually they are displayed on the screen of a respirator and serve for assessment of adequacy of ventilation, a condition of respiratory tracts, spontaneous respiratory activity of the patient and so on. These indicators can be expressed as figures, schedules and loops. Usually the doctor himself chooses the most convenient for it display option. Besides, depending on respirator model, on its screen indicators of a kapnografiya, oxygen concentration on a breath, a pulsoksimetriya can be also shown (separate sensors for each indicator are required). Also important indicators are temperature in a humidifier (if it is used) and a condition of food of a respirator (from network or the accumulator if it is used). Usually at an exit of the measured parameters out of the set limits the alarm works and the sound and visual signal is given.
When carrying out to the patient of artificial ventilation of the lungs, indicators of gas composition of blood very much are important. Usually they are measured by means of sampling of an arterial or venous blood with their subsequent studying with the special analyzer. After carrying out the analysis listing of results which are studied by the doctor is made.