Mechanical Ventilation: Approaches and Special Considerations

2018 ◽  
Author(s):  
Adrian A. Maung ◽  
Lewis J Kaplan
Keyword(s):  
Mechanical Ventilation ◽  
Respiratory Failure ◽  
Acute Respiratory Failure ◽  
Key Words ◽  
Spontaneous Breathing ◽  
Functional Unit ◽  
Spontaneous Breathing Trial

In this chapter, we complete the discussion of mechanical ventilation by examining approaches to mechanical ventilation for different patient populations and how to assess whether a patient is ready for liberation from mechanical ventilation. Each of the three chapters is intended to build on the preceding one and therefore establishes a functional unit with regard to mechanical ventilation, whether it is provided in an invasive or a noninvasive fashion.  This review contains 1 Figure, 1 Table and 31 references Key Words: acute respiratory failure, ARDS, mechanical ventilation liberation, spontaneous breathing trial, tracheostomy 

Mechanical Ventilation: Approaches and Special Considerations

2018 ◽  
Author(s):  
Adrian A. Maung ◽  
Lewis J Kaplan
Keyword(s):  
Mechanical Ventilation ◽  
Respiratory Failure ◽  
Acute Respiratory Failure ◽  
Key Words ◽  
Spontaneous Breathing ◽  
Functional Unit ◽  
Spontaneous Breathing Trial

In this chapter, we complete the discussion of mechanical ventilation by examining approaches to mechanical ventilation for different patient populations and how to assess whether a patient is ready for liberation from mechanical ventilation. Each of the three chapters is intended to build on the preceding one and therefore establishes a functional unit with regard to mechanical ventilation, whether it is provided in an invasive or a noninvasive fashion.  This review contains 1 Figure, 1 Table and 31 references Key Words: acute respiratory failure, ARDS, mechanical ventilation liberation, spontaneous breathing trial, tracheostomy 

Noninvasive and Invasive Ventilatory Support I

2018 ◽  
Author(s):  
Pauline K. Park ◽  
Nicole L Werner ◽  
Carl Haas
Keyword(s):  
Mechanical Ventilation ◽  
Respiratory Failure ◽  
Acute Respiratory Failure ◽  
Key Words ◽  
Noninvasive Ventilation ◽  
Ventilatory Support ◽  
Underlying Disease ◽  
Iatrogenic Injury ◽  
Pulmonary Mechanics

Invasive and noninvasive ventilation are important tools in the clinician’s armamentarium for managing acute respiratory failure. Although these modalities do not treat the underlying disease, they can provide the necessary oxygenation and ventilatory support until the causal pathology resolves. Care must be taken, as even appropriate application can cause harm. Knowledge of pulmonary mechanics, appreciation of the basic machine settings, and an understanding of how common and advanced modes function allow the clinician to optimally tailor support to the patient while limiting iatrogenic injury. This first chapter reviews pulmonary mechanics, machine settings, and current options for noninvasive and invasive support of respiratory failure. This review contains 7 figures, 3 tables and 44 references Key Words: hypoxemia, hypercapnia, mechanical ventilation, noninvasive ventilation, respiratory failure

Noninvasive and Invasive Ventilatory Support I

2018 ◽  
Author(s):  
Pauline K. Park ◽  
Nicole L Werner ◽  
Carl Haas
Keyword(s):  
Mechanical Ventilation ◽  
Respiratory Failure ◽  
Acute Respiratory Failure ◽  
Key Words ◽  
Noninvasive Ventilation ◽  
Ventilatory Support ◽  
Underlying Disease ◽  
Iatrogenic Injury ◽  
Pulmonary Mechanics

Invasive and noninvasive ventilation are important tools in the clinician’s armamentarium for managing acute respiratory failure. Although these modalities do not treat the underlying disease, they can provide the necessary oxygenation and ventilatory support until the causal pathology resolves. Care must be taken, as even appropriate application can cause harm. Knowledge of pulmonary mechanics, appreciation of the basic machine settings, and an understanding of how common and advanced modes function allow the clinician to optimally tailor support to the patient while limiting iatrogenic injury. This first chapter reviews pulmonary mechanics, machine settings, and current options for noninvasive and invasive support of respiratory failure. This review contains 7 figures, 3 tables and 44 references Key Words: hypoxemia, hypercapnia, mechanical ventilation, noninvasive ventilation, respiratory failure

scholarly journals Product of driving pressure and respiratory rate for predicting weaning outcomes

2021 ◽  
Vol 49 (5) ◽  
pp. 030006052110100
Author(s):  
Ju Gong ◽  
Bibo Zhang ◽  
Xiaowen Huang ◽  
Bin Li ◽  
Jian Huang
Keyword(s):  
Mechanical Ventilation ◽  
Respiratory Rate ◽  
Spontaneous Breathing ◽  
Spontaneous Breathing Trial ◽  
Plateau Pressure ◽  
Driving Pressure ◽  
Failure Group ◽  
Rapid Shallow Breathing Index ◽  
Weaning Failure ◽  
Shallow Breathing

Objective Clinicians cannot precisely determine the time for withdrawal of ventilation. We aimed to evaluate the performance of driving pressure (DP)×respiratory rate (RR) to predict the outcome of weaning. Methods Plateau pressure (Pplat) and total positive end-expiratory pressure (PEEPtot) were measured during mechanical ventilation with brief deep sedation and on volume-controlled mechanical ventilation with a tidal volume of 6 mL/kg and a PEEP of 0 cmH2O. Pplat and PEEPtot were measured by patients holding their breath for 2 s after inhalation and exhalation, respectively. DP was determined as Pplat minus PEEPtot. The rapid shallow breathing index was measured from the ventilator. The highest RR was recorded within 3 minutes during a spontaneous breathing trial. Patients who tolerated a spontaneous breathing trial for 1 hour were extubated. Results Among the 105 patients studied, 44 failed weaning. During ventilation withdrawal, DP×RR was 136.7±35.2 cmH2O breaths/minute in the success group and 230.2±52.2 cmH2O breaths/minute in the failure group. A DP×RR index >170.8 cmH2O breaths/minute had a sensitivity of 93.2% and specificity of 88.5% to predict failure of weaning. Conclusions Measurement of DP×RR during withdrawal of ventilation may help predict the weaning outcome. A high DP×RR increases the likelihood of weaning failure. Statement: This manuscript was previously posted as a preprint on Research Square with the following link: https://www.researchsquare.com/article/rs-15065/v3 and DOI: 10.21203/rs.2.24506/v3

Comparative study between noninvasive positive pressure ventilation and invasive mechanical ventilation in patients with respiratory failure

QJM ◽  
2021 ◽  
Vol 114 (Supplement_1) ◽  
Author(s):  
Mohammed N Al Shafi'i ◽  
Doaa M. Kamal El-din ◽  
Mohammed A. Abdulnaiem Ismaiel ◽  
Hesham M Abotiba
Keyword(s):  
Intensive Care Unit ◽  
Mechanical Ventilation ◽  
Intensive Care ◽  
Respiratory Failure ◽  
Acute Respiratory Failure ◽  
Positive Pressure Ventilation ◽  
Invasive Mechanical Ventilation ◽  
Noninvasive Positive Pressure Ventilation ◽  
Positive Pressure ◽  
Significant Difference

Abstract Background Noninvasive positive pressure ventilation (NIPPV) has been increasingly used in the management of respiratory failure in intensive care unit (ICU). Aim of the Work is to compare the efficacy and resource consumption of NIPPMV delivered through face mask against invasive mechanical ventilation (IMV) delivered by endotracheal tube in the management of patients with acute respiratory failure (ARF). Patients and Methods This prospective randomized controlled study included 78 adults with acute respiratory failure who were admitted to the intensive care unit. The enrolled patients were randomly allocated to receive either noninvasive ventilation or conventional mechanical ventilation (CMV). Results Severity of illness, measured by the simplified acute physiologic score 3 (SAPS 3), were comparable between the two patient groups with no significant difference between them. Both study groups showed a comparable steady improvement in PaO2:FiO2 values, indicating that NIPPV is as effective as CMV in improving the oxygenation of patients with ARF. The PaCO2 and pH values gradually improved in both groups during the 48 hours of ventilation. 12 hours after ventilation, NIPPMV group showed significantly more improvement in PaCO2 and pH than the CMV group. The respiratory acidosis was corrected in the NIPPV group after 24 hours of ventilation compared with 36 hours in the CMV group. NIPPV in this study was associated with a lower frequency of complications than CMV, including ventilator acquired pneumonia (VAP), sepsis, renal failure, pulmonary embolism, and pancreatitis. However, only VAP showed a statistically significant difference. Patients who underwent NIPPV in this study had lower mortality, and lower ventilation time and length of ICU stay, compared with patients on CMV. Intubation was required for less than a third of patients who initially underwent NIV. Conclusion Based on our study findings, NIPPV appears to be a potentially effective and safe therapeutic modality for managing patients with ARF.

Noninvasive mechanical ventilation as a palliative treatment of acute respiratory failure in patients with end-stage solid cancer

2004 ◽  
Vol 18 (7) ◽  
pp. 602-610 ◽  
Author(s):  
Annamaria Cuomo ◽  
Monica Delmastro ◽  
Piero Ceriana ◽  
Stefano Nava ◽  
Giorgio Conti ◽  
...  
Keyword(s):  
Mechanical Ventilation ◽  
Respiratory Failure ◽  
Acute Respiratory Failure ◽  
Palliative Treatment ◽  
Solid Cancer ◽  
Noninvasive Mechanical Ventilation ◽  
End Stage
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