Mechanical Ventilation- Why do we do it? Goals and Indications
Mechanical ventilation is a supportive process in that we are aiming to treat the underlying cause of the patients problem whilst we support their lung function. Hopefully once the underlying problem is solved we can then take the patient off the ventilator.
Very basically then;
Goals
Normalise arterial blood gas:
- Normalise acid base balance
- Normalise ventilation
- Normalise oxygenation.
Remove or reduce the patients work of breathing by unloading the respiratory muscles. We need to aim to do this in a synchronised manner.
Indications
Type I Respiratory failure- Hypoxeamic failure.
- Low oxygen status for example caused by:
- Congestive heart failure
- ARDS
- Pulmonary embolism
Type II Respiratory failure- Hypercapnic failure.
- High carbon dioxide for example caused by:
- Chronic obstructive airways disease
- Drugs
- Neuromuscular disease.
Airway Protection
- Airway swelling
- Surgery
- Trauma
Please go to Ollie Pooles fabulous YouTube resource for the learning this post was based on….
Mechanical Ventilation
- Peak and Plateau Pressure
- AC versus SIMV mode
- Positive End Expiratory Pressure (PEEP)
- Increase the rate or tidal volume?
- Phases of a breath- I:E ratio and cycle time
- Intubation
- Ventilation screen- what do those numbers mean?
- Pressure Support
- Modes of ventilation I
- Modes of ventilation II
- Physiologic effects
- Physiologic goals
- How do I describe how my patients ventilation?
- Trigger, Limit and Cycle
- Pressure support ventilation graphs
- ARDS and Proning
- 6 ways to be better with Bag-Valve-Mask
- Terminology
- Phase Variables
- Airway Pressure Release Ventilation (APRV)
- Pressure Volume Loop
- Lung compliance in volume controlled ventilation
- Pressure/Volume/Flow graphs
- A-a gradient
- Goals and Indications
- Anatomy of the Endotracheal Tube
- Lung Compliance
- Ventilation/Perfusion V/Q matching
- Ventilator Induced Lung Injury (VILI)
- Ventilator Associated Pneumonia (VAP)
- Phase variables...again...
- Capnography
Guidelines for the management of tracheal intubation in critically ill adults
Having read the guidelines I made these infographics. They are FREE. Just let me know your email address and they will be sent to you.