What is
The Option?
Hendri pangestu
• Airway equipment is any equipment used to help keep a patient's
airway open and to aid administration of oxygen/anaesthesia to the
patient's airway. Examples of airway equipment are:
• A face mask
• An oropharyngeal airway
• A tracheal tube
• A patient must always have a patent airway to keep them alive for
their anaesthetic.
• Airway equipment is not always used for an anaesthetic, but it may be
required suddenly. So airway equipment should always be nearby,
working and clean, to allow a patient to have a patent airway and
therefore a safe anaesthetic.
VENTILASI PARU
Konsep Dasar PROSES MEKANIK, KELUAR
MASUKNYA UDARA DARI LUAR
KE DALAM PARU DAN
SEBALIKNYA YAITU BERNAFAS
EKSTERNA
PERTUKARAN GAS
TERJADI ANTARA UDARA DALAM
ALVEOLUS DENGAN DARAH DALAM
PROSES KAPILER, PROSESNYA DISEBUT DIFUSI
RESPIRASI PERTUKARAN GAS
PERTUKARAN GAS ANTARA DARAH
DENGAN SEL JARINGAN
INTERNA
UTILISASI O2
RAW
AIRWAY
CL
LUNG
COMPLIANCE (COMPL)
Definisi,
Rasio perubahan volume akibat terjadinya
perubahan pressure V/P
BALON
Terbagi 2;
Compl paru (edema paru, fibrosis, surfactan
<<)
Kaku Elastis Compl dinding dada (obesitas, distensi
abdomen)
Low compliance
Edema paru, pneumonia berat, ARDS, efusi
pleura, hematopneumotoraks, abdominal
LOW HIGH pressure >>: u/ memasukkan volume
COMPLIANCE COMPLIANCE yang diinginkan dibutuhkan pressure yg
lebih besar.
High compliance
Muscle relaxant, COPD, open chest dgn
pressure yg kecil dapat tidal volume yg
masuk besar
AIRWAY RESISTANCE
BRONKOKONSTRIKSI:
(RAW) HISTAMIN
BRONKUS
NORMAL
PRESSURE
FLOW =
RESISTANCE OBSTRUKSI:
MUKUS/SEKRET
PRESSURE
FLOW =
RESISTANCE
PRESSURE
FLOW = BRONKODILATASI:
EPINEFRIN
RESISTANCE AMINOFILIN
BETA 2 AGONIS
AIRWAY RESISTANCE
(RAW)
PRESSURE
ETT TERLALU
KECIL FLOW =
RESISTANCE
BRONKOSPASME
TUMOR/SEKRET
KOLAPS/ATELEKTASIS
STRUKTUR ANATOMI
Trakea
CABANG BRONKUS
Bronkus
primer
Dari lubang hidung sampai
bronkiolus terminalis disebut Bronkus
area konduksi (penghantar), sekunder
sedangkan dari bronkiolus
sampai alveoli disebut area Bronkus
respirasi (tempat pertukaran gas) tersier
Zona konduksi
Dari trakea sampai bronkiolus
banyak mengandung supporting Bronkiolus
cartilage (tlg rawan) yg
berfungsi menjaga agar jalan
nafas tetap terbuka Bronkiolus
terminalis
UDARA BEBAS:
PiO2 : 20.9 % x 760 = 159 mmHg
PiCO2 : 0.04 % x 760 = 0.3 mmHg
PiN2 : 78.6 % x 760 = 597mmHg ALVEOLUS
PiH2O : 0.46 % x 760 = 3.5 mmHg
N2 H2O
KAPILER PARU
PAN2: PAH2O:
573 mmHg 47 mmHg
PROSES DIFUSI
PAO2: PACO2:
104 mmHg 40 mmHg
O2 O2 CO2 O2
PaO2: 104
PaO2: 40 mmHg
mmHg CO2
CO2 PaCO2: 45 PaCO2: 40
mmHg mmHg
Nasopharynx Nasal Air Passages
Upper Airway Soft Palate Hard Palate
Pharynx
Uvula Mouth
Oropharynx Tounge Upper Airway
Epiglottis
Larynx Vocal Cords
Esophagus Thyroid Cartilage
Crico-Thyroid Membrane
Cricoide Cartilage
Trachea
Alveoli
Lower Airway Lower Airway
Carina
Bronchi
Lung
Bronchioles
• Subdivides into 23rd gen
• In the 10th gen the
Bronchioles begin,
diameter < 1mm
• Up to 16th gen still no
gas exchange
• The 23rd gen begin
Alveoli
Φ 0.3mm
Basic airway management , For COVID19
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