Ventilation- Concept building

Landing page, Ventilation, 2000 hrs,Jul 11,2020)

Jeevan saans ke saath juda hai. Saans ki kriya hawa se oxygen kheench kar fefde mein le jaati hai, jahan jhilli (Alveolo-capillary membrane) ko par kar dil ki dhadkan, khoon ke dwara, uss oxygen ko poorey shareer ke har ang mein pahunchati hai. Khaali aaney se acha hai kuch upyog karna ,to shareer mein kachre ke roop mein utpan carbon di oxide ko yeh khoon vapis fefde / Alveoli mein le aata hai, jahan oxygen se ulti disha mein carbo di oxide vayu mandal mein nikal jaati hai. yeh carbon di oxide vriksh /ped /paudhe khana banane ke liye istemaal karte hain (Dhoop aur Chlorophyll se-Photosynthesis) aur apna kachra Oxygen ham jeevon ke liye ,vayumandal mein nikaal dete hain. YAHI JEEVAN HAI, ye hee kriya hai, aapsee sehyog ki. (Prithvi par koi cheez bekar nahi hai, Kissi ka kachra, kissi ka labh)

Saralta ke liye hum isko teen (3) hisson mein baant kar padhenge. Pehla hissa “Ventilation”, doosra “Oxygen aur carbon di oxide ka blood / khoon mein ghulkar shareer/fefde ka safar“, aur teesra, “ang / tissue ka blood ke saath oxygen aur carbon di oxide ka exchange / aadan pradaan”.Respiratory system ki Concept building inhi ke landing pages se shuru hogi.

Anaesthesia / Nishchetna mein ventilation ko stambh ya pillar ke roop mein samajhna jaroori hai. Pehle hum log ek rai ho jayein ki iski paribhasha ya definition kya , taaki mein aur aap, ise ek hi nazar se dekhen.

Ventilation ya Alveolar ventilation vo prakriya ya process hai jo ki hamare dheeme dheeme chaati (chest wall) fulane aur khaali karne ke karan do (2) dishayon mein prabhaav dalta hai. Vayumandal (Atmosphere) ya bahar ki hawa se oxygen hamare fefde (Alveoli) tak kheench kar hamein oxygen dete hai, aur shareer se utpan carbon di oxide fefde (Alveoli) se nikal kar vayumandal (atmosphere ) mein pahunchti hai .

Yaani Alveolar ventilation se oxygen aur carbon di oxide imandaari / sharafat se apni jagah badal lete hain. Iska bigadna hi bimari hai or iska sambhalna hi Anaesthesiologist /Nishchetak ki jimmevaari hai. Aage badte hue hum isi pehlu ko tarah tarah ke nazariye se dekhenge.

Isi soch/ philosophy se agar hum poori kriya ko dekhenge ,to kai bahumulya seekh bhi milegi ki kudrat kaise mushkil sawalon ka aasan aur “low energy ” jawaab nikaalti hai, aur kaise alag paristhiti mein usi gyaan ka prayog / istemaal doosre janwaron dwara ho sakta hai.

Hamein yeh bhi dikhega ke motey taur par yahi model shareer ke kai aur systems mein dohraya gaya hai, bus naam doosra hai ,basic tareeka wohi hai.

Sabhi vishyon ki tarah, kahani saral tareekon se shuru hogi aur dheere dheere complexity aati jayegi. ( Dhyan rahe difficulty nahi complexity likha hai menen.) Yahi cheez sangeet ya music mein rehti hai, yahi bhasha hai, A to Z seekhiye aur novel likh deejiye, ya 0 se 9 seekho or ganit / maths ki kitab / concept likh daalo ya MS Excel mein kaam karo, formula likho.

Yeh bhi ek jeevan ke liye seekh hai, ki simple fundamental concept se hi Complex Concepts bante hain, ya yoon kahiye kisi bhi mushkil cheez ki neev / foundation ke stambh / pillar simple concept rehten hai jinko poora samjhne mein smay nahi lagaya gaya , ya samjhaya nahi gaya, ya poora samajh nahi aya to agey mushkil aatee hai.

In concepts ko hum “keywords” ya “key concepts” bhi keh sakte hein (shabd / shabdon ki lambai ke anusaar). Kyunki hum anaesthesia poora to website mein nahi padha sakte , magar keywords / dots / bindu ko jodkar ek aasan karne wala, aur samajhne wala dhancha bana sakte hein. To isi liye ” Respiratory system” ki kahani jo ki hamari rozi roti ki daastan ” ( bread butter ) hai , Ventilation se shuru hoti hai.

Shayad yeh introduction thodi lambi lag rahee hogi, magar ye aane waley lectures ka samay baandh rahi hai, ek disha dikha rahi hai, jisme roz pani peene ke liye roz kuan khodne ki zaroorat nahi.Thodi soch aur zoom in/out karke dekhne se naya topic samajhna har baar aur aasan ho jayega, aur shayad kuch jeevan upyogi seekh ,kudrat (nature ) ke design se. ya kaam karne ke tareeke se mil saktee hai. ( Biomimetics )

Dobara is paribhasha ko padhiye aur samajhiye. isme aakhri do(2) mudde jodna baakey hai. Saans ko chalney ki disha ,dimaag se aati hai aur hum kuch had tak isme badha daal saktey hain , jaise jaan kar saans rokna ya tez karna. Kyonki yeh karya 24 ghante chalna hai islley ise brain ne automatic kar diya hai. ab jeevit vyakti baaki dishaon mein dhyan laga sakta hai or dil or saans ke chalne ki speed ki phikar nahi karni padtee. Aur doosra ki jyadatar medical physiology aap seedhe khare insaan ke hissab se samajhte hein, lekin anaesthesia mein apko mareez hamesha leta hua milega, chahe seedha, side par ya pet ke bal ulta. kyoonki gravity ya gurutvakarshan samast jagah par kaam karte hai isliye ventilation position aur gravity mein bhi gehra rishta hai.

vayumandal ka kona to dikhta hai par doosra kona kya hai. isko hum Alveoli kahenge aur iska ek kalpanik roop man mein rachte hai, jo shakal se to alg hai lekin kaam bilkul uske jaisa karega.

Alveoli ek kalpanik (kyoonki isko abhi dikhana nahin hai, samjhana hai model se) kamra samajhiye. ek bantey hue makaan ki kalpana kijiye jisme foundation ke baad garmi ke dino mein har kamre mein Chaukhat aur darwaze (door) lagey hain par diwaron aur chaath (roof) ke lite itein ( bricks ) nahi ayee.mazdoor log har kamre meinbachaav ke liye purani dhoti se deewar aur chaath (roof) bana lete hein aur usko geela kar ke kamra thanda rakhte hein. Bagal waley kamre mein bhi yahi kiya gay hai par donon pardon (curtain/ membrane ke beech 2 pipe bhi chal rahein hain. Mudde ki baat yeh hai ke ye Aveoli “Hawa” or “Paani” se bigad sakta hai. Yaani hamare fefde itne nazuk hai ki normal se kum ya zyada hawa ya paani si kharab ho saktein hain ya bigad saktey hain.

to ab man mein photo yeh bana lijiye ki ek pipe hai jiska ek kona vayu mandal hai , pipe shareer mein ja kar Alveoli mein khulta hai .kaidi (prisoner aadan praadan ki tarah oxygen aur carbon di oxide vipreet (opposite direction mein chalte hain , raah mein mulakaat bhi hoti hai, ghulte milte bhi hai aur fir doosree disha mein chal padte hain. is Kahani ke actors aur kahani ke set ka badalna hi ventilation ki tarah tarah ki beemari or complexity ko janam deta hai.

udharan ke liye hum kuch pehloo ko badal kar dekhte hain aur aagey aane waley Blogs mein vistrit /detaile jaankari dekhenge. Kisi bhi kone se shuru kiya ja sakta hai vayu mandal se fefde ke Alveoli se.har point alag se likha jayega , taaki baad mein use technical topic se link kar diya jaye.

aap sabh jyadatar vayumandal mein saans lete hain, par surgery mein GA yaani anaesthesia ke dauran kritrim vayumandal hota hai. mareez bhagwaan nahi doctor ki banayi oxygen aur davai ke anupaat mein saan leta hai. ( Hypoxia, Hyperoxia, Rebreathing, Dry air)

patient apne aap saans le sakta hai ya machine dwara.( Spontaneous ventilation , Muscles of respiration, intrapleural space,pneumothorax

machine se bina tube daale ya endotracheal/ nasotracheal/ tracheostomy tube ke saath.machine se dhodi der ya jyaada der. ( positive pressure ventilation, mechanical ventilation, Non Invasive ventilation, CPAP, BIPAP, Dead space,Humidification, ventillator associated pneumonia)

Vayumandal sea level samudra tal par normal pressure par kaha jata hai 1 atmosphere. ye Pahar par kam ho jata hai aur samudra tal jaise pandubi / submarine mein jyada ho jyata hai.(Barotrauma, Pumonary oedema, Negative pressure pulmonary oedema,Surfactant,PAO2)

Hawa mein hamare kaam ki teen gas hain oxygen, carbon di oxide aur nammi / water vapour. Inme oopar neeche badlav ho sakta hai.(Oxygen therapy, Hypoxic hypoxia, Hyperbaric physiology and Anaesthesia, Physiology and Anaesthesia at high altitude ).

Saans chalne ka nirdesh dimag se aata hai. samanya kaal mein yeh nirdesh shareer ki do abhilashyan poori karte hai. Oxygen ki blood mein matra sahi rahe aur shareer se carbon di oxide bahar nikal jaye. ye nirdesh teen bhag mein aata hai. Kitnee baar saans lena hai (RR-Respiratory rate), kitna bad saans lena hai (VT– Tidal voloume), kis ley se saans lena hai (Rhythm).Do paristhiti mein gadbad ho sakte hai. Ya to kissi karan dimag / Respiratory centre galat nirdesh de raha hai, (Jaise chot, dawai etc ke karan) ya nirdesh theek hai par chaati aur fefde uska sahi palan nahi kar paa rahe. unki majboori kamjori,beemari,injury/ chot etc ho sakti hai. (Hypoventilation, Central cause of Apnoea, Peripheral cause of apnoea, Hyperventilattion, Respiratory acidosis,Respiratory Alkalosis.)

Upar likhe RR ko agar hum VT se guna / multiply kar lein to humein samajh mein aata hai ki ek minute mein kitnee hawa andar ya bahr ja rahe hai (isse MV ya Minute ventilation kehte hain. iske baal ki khaal hum baad mein nikalenge.magar is prakriya ko agar instruments dwara nap jaya to ussey LFT- Lung Function test kehte hain. ( Static lung Voloume and capacities, Dynamic lung Functions, barotrauma).

Body mein hawa aaram se ja saktee hai ya usey rukavat ho saktee hai jaise asthma ka patient ya Foreign body, thick secretions. Rukavat Alveoli level pahunch kar membrane paar karne mein bhi ho saktee hai( Resistance,Laminar flow, Turbulent Flow,Pulmonary oedema)

Oxygen Flux -jawab sheegra hee.

Tidal voloume-jawab sheegra hee.

Respiratory rate-jawab sheegra hee.

Minute ventilation-jawab sheegra hee.

Dead Space-jawab sheegra hee.

Anatomical dead space-jawab sheegra hee.

Equipment dead space-jawab sheegra hee.

Physiological dead space-jawab sheegra hee.

Alveolar ventilation-jawab sheegra hee.

to hum ne dekha ke ek chotta sa concept saans ka andar bahar hona kitna bada “Word Cloud” generate kar raha hai. yahi iss topic ventilation ki Simplicty hai aur Complexity hai. Isi se ham “Human Pathophysiology ka Model” banate jayenge aur aage badte jayenge.

hamein oxygen kyon chaiye ? agar zaroori hai to hamaare shareer mein thoda stock kyon nahi rakh sakte?Kya oxygen vish hai ya amrit ? Ya Dono!

jawab sheegra hee.

Kya carbon di oxide shareer ka kachra hai ?

jawab sheegra hee.

Suvidha ke liye hum blog mein bracket ke keywords ko kram anusaar (Alphabetically ) likh deten hain aur aage aane walon blog se hyperlink karte jayenge. mere liye yeh bhi acha hai agar aap isko poorey blog ka index page or philosophy bhi samjhenge.

Published by Prof GS Jheetay MD (Anaesthesiology)

I am a Professor in Anaesthesiology in a Medical College in UP and retired from Indian Air Force. I am involved in active work and reflection during Covid 19 Pandemic has given me a motivation to share and also learn from others. I will share professional knowledge and general life experience on my site, blog and various other modes of learning/entertainment.Why Roman Hindi,What is the common thread that will bind my information etc is available on my site. For your satisfaction and mine,please read it. Regards

21 thoughts on “Ventilation- Concept building

  1. It’s really informative sir. Aur hum aapke future contents ke liye wait kar rahe hai.
    A nice way to express something informative.

    Like

  2. I have read physiology of respiration so.many times ..but never learned it in such imagination of room and always learnt formula of minute volume ..but you made me to realise that how things can be learnt in.simpler way by analyzing it with daily life

    Like

  3. I have read about repiratory physiology earlier so.many times ..but never got inderstanding in such a way of taking concept of room ..and definition of minute volume..its really great to learn things while imagining concept sir …

    Like

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