Mechanical ventilation indications for use
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Vishnu Vardhan Serla M.B.B.S. [2]
Indications for Use
The indications of the mechanical ventilation is as follows:[1][2]
- The three most common indications for mechanical ventilation are
1) inadequate oxygenation 2) inadequate ventilation 3) inability to protect the airway
Other indications for mechanical ventilation include the following:
- Bradypnea
- Tachypnea (respiratory rate >30 breaths per minute)
- Apnea with respiratory arrest including cases from intoxication
- Acute respiratory distress syndrome
- Vital capacity less than 15 mL/kg
- Minute ventilation greater than 10 L/min
- Reduced respiratory drive
- Abnormalities of the Chest wall
- Respiratory muscle fatigue
- Intrapulmonary shunt
- V/Q mismatch(ventilation-perfusion)
- Decreased Functional Residual Capacity
- Arterial partial pressure of oxygen (PaO 2) with a supplemental fraction of inspired oxygen (FIO 2) of less than 55 mm Hg
- Alveolar-arterial gradient of oxygen tension (A-a DO 2) with 100% oxygenation of greater than 450 mm Hg
- Coma
- Hypotension due to sepsis, shock, CHF
- Acute partial pressure of carbon dioxide (PaCO 2) greater than 50 mm Hg with an arterial pH less than 7.25
- Chronic obstructive pulmonary disease (COPD)
- Acute respiratory acidosis with
- Partial pressure of carbon dioxide (pCO2) > 50 mmHg
- pH < 7.25, which may be due to paralysis of the diaphragm due to
- Guillain-Barré syndrome
- Myasthenia Gravis
- spinal cord injury
- The effect of anaesthetic and muscle relaxants
- Increased work of breathing as evidenced by significant tachypnea, retractions, and other physical signs of respiratory distress
- Hypoxemia with arterial partial pressure of oxygen (PaO2) with supplemental fraction of inspired oxygen (FiO2) < 55 mm Hg
- Neuromuscular disease
References
- ↑ Tung A (1997). "Indications for mechanical ventilation". Int Anesthesiol Clin. 35 (1): 1–17. PMID 9113518.
- ↑ Kreppein U, Litterst P, Westhoff M (2016). "[Hypercapnic respiratory failure. Pathophysiology, indications for mechanical ventilation and management]". Med Klin Intensivmed Notfmed (in German). 111 (3): 196–201. doi:10.1007/s00063-016-0143-2. PMID 26902369.