air way & ventilation

8/18/2019 Air Way & Ventilation

1/40

BRHEATHING

(OXYGENATION & VENTILATION )for advance


2/40

Objektf

• !e"a#a" anato" $%oo'ernafa%an

• a*at "ena "a%aa# *ernafa%an

• a*at "entataak%ana "a%aa#*ernafa%an


3/40

+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


4/40

+o"*onen ernafa%an


5/40

+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)


6/40

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


7/40

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.


8/40

Ga% Ec#an'e & ce Re%*ratonBa%c 2cence


9/40

Ga% Ec#an'e & ce Re%*ratonBa%c 2cence


10/40

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


11/40

rn%* *e"a%,kan ok%'en

• f,%=

• A*aka# df,%


12/40

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'


13/40


14/40

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#)


15/40

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)


16/40

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)


17/40

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


18/40

A*aka# Ga'a Nafa%

• T*e 8 #.*ok%a (aO0 97 ""H')

• T*e 0 H.*ercarba (1O0 < 97""H')


19/40

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


20/40

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


21/40

H,b,n'an aO0 den'an2at,ra%


22/40

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'


23/40

+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,


24/40

en.ebab Ga'a nafa% T*e I

• +etn''an ek%tre"

• Gan'',an df,% *ar,

•

R'#t to eft %#,nt


25/40

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%% *,*


26/40

1ANOGRAH


27/40

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')


28/40

Gradent ET1O0 dan aO0

• P","n.a 3 "" H'

• !enn'kat *ada keadaan – !enn'katn.a dead %*ace

– V/Q "%"atc#>

– %#,ntn'


29/40

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


30/40

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%)


31/40

Tanda ernafa%an tdakadek,at

• T*e Nafa% – 1.ne %toke%

– +,%"a,

– Bot

– H*erventa%

– A'ona

– 2#ao: – a*nea


32/40

enderta den'an anca"an

ernafa%an

• ro:nn'

• +ebakaran daa" r,an' tert,t,*

•

!en'#r,* 1o0/1O


33/40

Tataak%ana

• Ok%'en

• Venta%


34/40

Ok%'en

• Aat ok%'en terba' – ed o.'en devce

– Non ed o.'en devce


35/40

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


36/40

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


37/40

+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


38/40

Venta%

• 6ack%on Ree%e

• Ba' Ventaton !a%k

• Ventator


39/40

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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air way & ventilation

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