Dead space is the volume of air that is inhaled that does not take part in the gas exchange, because it either remains in the conducting airways or reaches alveoli that are not perfused or poorly perfused. It means that not all the air in each breath is available for the exchange of oxygen and carbon dioxide. Mammals breathe in and out of their lungs, wasting that part of the inhalation which remains in the conducting airways where no gas exchange can occur.
A rebreather is a breathing apparatus that absorbs the carbon dioxide of a user's exhaled breath to permit the rebreathing (recycling) of the substantially unused oxygen content, and unused inert content when present, of each breath. Oxygen is added to replenish the amount metabolised by the user. This differs from open-circuit breathing apparatus, where the exhaled gas is discharged directly into the environment. The purpose is to extend the breathing endurance of a limited gas supply, and, for covert military use by frogmen or observation of underwater life, eliminating the bubbles produced by an open circuit system and in turn not scaring wildlife being filmed. A rebreather is generally understood to be a portable unit carried by the user. The same technology on a vehicle or non-mobile installation is more likely to be referred to as a life-support system.
Hypercapnia (from the Greek hyper = "above" or "too much" and kapnos = "smoke"), also known as hypercarbia and CO2 retention, is a condition of abnormally elevated carbon dioxide (CO2) levels in the blood. Carbon dioxide is a gaseous product of the body's metabolism and is normally expelled through the lungs. Carbon dioxide may accumulate in any condition that causes hypoventilation, a reduction of alveolar ventilation (the clearance of air from the small sacs of the lung where gas exchange takes place) as well as resulting from inhalation of CO2. Inability of the lungs to clear carbon dioxide, or inhalation of elevated levels of CO2, leads to respiratory acidosis. Eventually the body compensates for the raised acidity by retaining alkali in the kidneys, a process known as "metabolic compensation".
Oxygen therapy, also referred to as supplemental oxygen, is the use of oxygen as medical treatment. Supplemental oxygen can also refer to the use of oxygen enriched air at altitude. Acute indications for therapy include hypoxemia, carbon monoxide toxicity and cluster headache. It may also be prophylactically given to maintain blood oxygen levels during the induction of anesthesia. Oxygen therapy is often useful in chronic hypoxemia caused by conditions such as severe COPD or cystic fibrosis. Oxygen can be delivered via nasal cannula, face mask, or endotracheal intubation at normal atmospheric pressure, or in a hyperbaric chamber. It can also be given through bypassing the airway, such as in ECMO therapy.
A resuscitator is a device using positive pressure to inflate the lungs of an unconscious person who is not breathing, in order to keep them oxygenated and alive. There are three basic types: a manual version consisting of a mask and a large hand-squeezed plastic bulb using ambient air, or with supplemental oxygen from a high-pressure tank. The second type is the expired air or breath powered resuscitator. The third type is an oxygen powered resuscitator. These are driven by pressurized gas delivered by a regulator, and can either be automatic or manually controlled. The most popular type of gas powered resuscitator are time cycled, volume constant ventilators. In the early days of pre-hospital emergency services, pressure cycled devices like the Pulmotor were popular but yielded less than satisfactory results. Most modern resuscitators are designed to allow the patient to breathe on his own should he recover the ability to do so. All resuscitation devices should be able to deliver more than 85% oxygen when a gas source is available.
A breathing apparatus or breathing set is equipment which allows a person to breathe in a hostile environment where breathing would otherwise be impossible, difficult, harmful, or hazardous, or assists a person to breathe. A respirator, medical ventilator, or resuscitator may also be considered to be breathing apparatus. Equipment that supplies or recycles breathing gas other than ambient air in a space used by several people is usually referred to as being part of a life-support system, and a life-support system for one person may include breathing apparatus, when the breathing gas is specifically supplied to the user rather than to the enclosure in which the user is the occupant.
A breathing mask is a mask that covers the mouth, nose, and optionally other parts of the face or head, designed to constrain and direct the wearer's breath to and/or from a particular breathing apparatus. It may mean, or be part of, one of these types:
An oxygen mask is a mask that provides a method to transfer breathing oxygen gas from a storage tank to the lungs. Oxygen masks may cover only the nose and mouth or the entire face. They may be made of plastic, silicone, or rubber. In certain circumstances, oxygen may be delivered via a nasal cannula instead of a mask.
The nasal cannula (NC) is a device used to deliver supplemental oxygen or increased airflow to a patient or person in need of respiratory help. This device consists of a lightweight tube which on one end splits into two prongs which are placed in the nostrils curving toward the sinuses behind the nose, and from which a mixture of air and oxygen flows. The other end of the tube is connected to an oxygen supply such as a portable oxygen generator, or a wall connection in a hospital via a flowmeter. The cannula is generally attached to the patient by way of the tube hooking around the patient's ears or by an elastic headband, and the prongs curve toward the paranasal sinuses. The earliest, and most widely used form of adult nasal cannula carries 1–3 litres of oxygen per minute.
The simple face mask (SFM) is a basic disposable mask, made of clear plastic, to provide oxygen therapy for patients who are experiencing conditions such as chest pain, dizziness, and minor hemorrhages. This mask is only meant for patients who are able to breathe on their own, but who may require a higher oxygen concentration than the 21% concentration found in ambient air. Patients who are unable to breathe on their own are placed on a medical ventilator instead. The simple face mask can deliver higher flow rates than nasal cannula for an FiO2 of 40–60% oxygen. Nasal cannula and simple face masks are described as low flow delivery systems.
A portable oxygen concentrator (POC) is a device used to provide oxygen therapy to people that require greater oxygen concentrations than the levels of ambient air. It is similar to a home oxygen concentrator (OC), but is smaller in size and more mobile. They are small enough to carry and many are now FAA-approved for use on airplanes.
An orinasal mask, oro-nasal mask or oral-nasal mask is a breathing mask that covers the mouth and the nose only. It may be a complete independent item, as an oxygen mask, or on some anaesthetic apparatuses, or it may be fitted as a component inside a fullface mask on underwater breathing apparatus, a gas mask or an industrial respirator to reduce the amount of dead space. It may be designed for its lower edge to seal on the front of the lower jaw or to go under the chin.
A breathing tube is a hollow component that can serve as a conduit for breathing. Various types of breathing tubes are available for different specific applications. Many of them are generally known by more specific terms.
Heated humidified high-flow therapy, often simply called high flow therapy, is a type of respiratory support that delivers a flow of medical gas to a patient of up to 60 liters per minute and 100% oxygen through a large bore or high flow nasal cannula. Primarily studied in neonates, it has also been found effective in some adults to treat hypoxemia and work of breathing issues. The key components of it are a gas blender, heated humidifier, heated circuit, and cannula.
A breathing circuit is those parts of a breathing apparatus, which direct the flow of supplied breathing gas to, and sometimes from, the user. The breathing circuit may be open, closed, or semi-closed, depending on whether breathing gas is recycled. A closed or semi-closed circuit will include components which remove carbon dioxide from the exhaled gas and add oxygen before it is delivered for inhalation, so that the mixture remains stable and suitable for supporting life. Terminology may vary slightly between fields of application. In diving and industrial rebreathers, the closed or semi-closed breathing circuit may also be called the loop, or breathing loop. In medical equipment the closed or semi-closed circuit may be called the circle system.
A built-in breathing system is a source of breathing gas installed in a confined space where an alternative to the ambient gas may be required for medical treatment, emergency use, or to minimise a hazard. They are found in diving chambers, hyperbaric treatment chambers, and submarines.
A Diving rebreather is an underwater breathing apparatus that absorbs the carbon dioxide of a diver's exhaled breath to permit the rebreathing (recycling) of the substantially unused oxygen content, and unused inert content when present, of each breath. Oxygen is added to replenish the amount metabolised by the diver. This differs from open-circuit breathing apparatus, where the exhaled gas is discharged directly into the environment. The purpose is to extend the breathing endurance of a limited gas supply, and, for covert military use by frogmen or observation of underwater life, to eliminate the bubbles produced by an open circuit system. A diving rebreather is generally understood to be a portable unit carried by the user, and is therefore a type of self-contained underwater breathing apparatus (scuba). A semi-closed rebreather carried by the diver may also be known as a gas extender. The same technology on a submersible or surface installation is more likely to be referred to as a life-support system.
The mechanism of diving regulators is the arrangement of components and function of gas pressure regulators used in the systems which supply breathing gases for underwater diving. Both free-flow and demand regulators use mechanical feedback of the downstream pressure to control the opening of a valve which controls gas flow from the upstream, high-pressure side, to the downstream, low-pressure side of each stage. Flow capacity must be sufficient to allow the downstream pressure to be maintained at maximum demand, and sensitivity must be appropriate to deliver maximum required flow rate with a small variation in downstream pressure, and for a large variation in supply pressure, without instability of flow. Open circuit scuba regulators must also deliver against a variable ambient pressure. They must be robust and reliable, as they are life-support equipment which must function in the relatively hostile seawater environment, and the human interface must be comfortable over periods of several hours.
High altitude breathing apparatus is breathing apparatus which allows a person to breathe more effectively at an altitude where the partial pressure of oxygen in the ambient atmospheric air is insufficient for the task or to sustain consciousness or human life over the long or short term.
A breathing apparatus or breathing set is equipment which allows a person to breathe in a hostile environment where breathing would otherwise be impossible, difficult, harmful, or hazardous, or assists a person to breathe. A respirator, medical ventilator, or resuscitator may also be considered to be breathing apparatus. Equipment that supplies or recycles breathing gas other than ambient air in a space used by several people is usually referred to as being part of a life-support system, and a life-support system for one person may include breathing apparatus, when the breathing gas is specifically supplied to the user rather than to the enclosure in which the user is the occupant.
