Mechanical ventilation resident survival guide

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Mechanical ventilation Resident Survival Guide Microchapters
Overview
Classification
Indications
FIRE
Mode and variable selection
Do's
Donts

Overview

Classification

Indications

The following are the indications of mechanical ventilation:

  • Cardiac or respiratory arrest
  • Tachypnea or bradypnea with respiratory fatigue or impending arrest
  • Acute respiratory acidosis
  • Refractory hypoxemia
  • Refractory hypoxemia (when the P a O 2 could not be maintained above 60 mm Hg with inspired O 2 fraction (F I O 2 )>1.0)
  • Inability to protect the airway associated with depressed levels of consciousness
  • Shock associated with excessive respiratory work
  • Inability to clear secretions with impaired gas exchange or excessive respiratory work
  • Newly diagnosed neuromuscular disease with a vital capacity <10 - 15 mL/kg
  • Short term adjunct in management of acutely increased intracranial pressure (ICP) intracranial pressure (ICP) 

Non-Invasive mechanical ventilation

Consider non-invasive mechanical ventilation especially in the following conditions:

  • COPD exacerbation
  • Cardiogenic pulmonary edema
  • Obesity hypoventilation syndrome
  • Patients with asthma or patients with non-cardiogenic hypoxemic respiratory failure

FIRE: Focused Initial Rapid Evaluation

A Focused Initial Rapid Evaluation (FIRE) should be performed to identify patients of severe acute respiratory failure and in need of immediate intervention.

Boxes in red signify that an urgent management is needed.

Abbreviations

Mode and variable selection

Do's

Donts

References

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