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Mechanical ventilation (main)
From WikEM
Background
Intubation and ventilation typically required for respiratory failure or airway proctection/severe altered mental status
- Categories of respiratory failure
- Type 1 - Hypoxemia
- Type 2 - Hypercarbia
- Type 3 - Perioperative
- Type 4 - Shock
Sections
Noninvasive ventilation
- CPAP
- BiPAP
Intubation
- Indications
- Absolute Contraindications
- Relative Contraindications (Mnemonics for Predicting Difficulties)
- Mnemonics
- Procedure
- Complications
- Special Situations
Deterioration after intubation
- Differential and management of deterioration after intubation
Ventilation settings
- Initial ventilation settings
- Lung Injury Strategy
- Obstruction Strategy
- Making Setting Changes
Ventilation modes
- Assist Control (AC)
- Synchronous Intermittent Mandatory Ventilation (SIMV)
- Pressure Support (PS)
- Pressure Regulated Volume Control (PRVC)
- CPAP
- Control Mode
Ventilator high pressures
- High pressure alarms
- Management
Recruitment maneuver
- Techniques for hypoxic ARDS patients
Ventilation weaning
- Weaning parameters
- Failure to wean
Extubation
- Extubating after brief periods on a ventilator (ex. intubation for agitated trauma patient)
Patient Positioning[1]
- HOB elevation > 30 degrees
- Reverse trendelenberg at 30 degrees in obese hypoventilaters
- Lateral decubitus for severe unilateral lung disease
- Good lung to Ground generally
- Good lung UP in these exceptions:
- Massive hemoptysis - prevent blood into dependent, good lung
- Large abscess - pus fills up dependent lung
- Unilateral emphysema - prevent hyperinflation
See Also
Mechanical Ventilation Pages
- Noninvasive ventilation
- Intubation
- Deterioration after intubation
- Ventilation settings
- Ventilation modes
- Ventilator high pressures
- Ventilator associated lung injury (VALI)
- Recruitment maneuver
- Ventilation weaning
- Extubation
- EBQ:ARDSnet
- Ideal Body Weight Estimation
References
- ↑ Greenwood J. Good Lung UP or DOWN? Maneuvers to Improve Oxygenation in Acute Respiratory Failure. Updated 7/15/2014. https://umem.org/educational_pearls/2464/.
