Mechanical ventilation indications for use: Difference between revisions
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Other indications for mechanical ventilation include the following: | Other indications for mechanical ventilation include the following: | ||
* Bradypnea | * Bradypnea | ||
* Tachypnea (>30 breaths | * Tachypnea (>30 breaths/minute) | ||
* Apnea with respiratory arrest including cases from [[intoxication]] | * Apnea with respiratory arrest including cases from [[intoxication]] | ||
* Acute respiratory distress syndrome | * Acute respiratory distress syndrome | ||
* Vital capacity less than 15 | * Vital capacity less than 15 ml/kg | ||
* Minute ventilation greater than 10 | * Minute ventilation greater than 10 Lts/min | ||
* Reduced respiratory drive | * Reduced respiratory drive | ||
* Abnormalities of the chest wall | * Abnormalities of the chest wall | ||
* Respiratory muscle fatigue | * Respiratory muscle fatigue | ||
* Intrapulmonary shunt | * Intrapulmonary shunt | ||
* V/Q mismatch(ventilation-perfusion) | * V/Q mismatch (ventilation-perfusion) | ||
* Decreased Functional Residual Capacity | * Decreased Functional Residual Capacity | ||
* Arterial partial pressure of oxygen ( | * Arterial partial pressure of oxygen (PaO<sub>2</sub>) with a supplemental fraction of inspired oxygen (FIO<sub>2</sub>) of less than 55 mm Hg | ||
* Alveolar-arterial gradient of oxygen tension (A-a | * Alveolar-arterial gradient of oxygen tension (A-a DO<sub>2</sub>) with 100% oxygenation of greater than 450 mm Hg | ||
* Coma | * Coma | ||
* Hypotension due to sepsis, shock, CHF | * Hypotension due to sepsis, shock, CHF | ||
* Acute partial pressure of carbon dioxide ( | * Acute partial pressure of carbon dioxide (PaCO<sub>2</sub>) greater than 50 mm Hg with an arterial pH less than 7.25 | ||
* [[Chronic obstructive pulmonary disease]] ([[COPD]]) | * [[Chronic obstructive pulmonary disease]] ([[COPD]]) | ||
* Acute [[respiratory acidosis]] with | * Acute [[respiratory acidosis]] with | ||
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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][3][4][5][6][7]
- 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 (>30 breaths/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 Lts/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 (PaO2) with a supplemental fraction of inspired oxygen (FIO2) of less than 55 mm Hg
- Alveolar-arterial gradient of oxygen tension (A-a DO2) with 100% oxygenation of greater than 450 mm Hg
- Coma
- Hypotension due to sepsis, shock, CHF
- Acute partial pressure of carbon dioxide (PaCO2) 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.
- ↑ Strøm T, Rian O, Toft P (February 2012). "[Fewer indications for sedation in mechanical ventilation therapy]". Ugeskr. Laeg. (in Danish). 174 (7): 406–9. PMID 22331041.
- ↑ Simonds AK (November 2016). "Home Mechanical Ventilation: An Overview". Ann Am Thorac Soc. 13 (11): 2035–2044. doi:10.1513/AnnalsATS.201606-454FR. PMID 27560387.
- ↑ Boldrini R, Fasano L, Nava S (February 2012). "Noninvasive mechanical ventilation". Curr Opin Crit Care. 18 (1): 48–53. doi:10.1097/MCC.0b013e32834ebd71. PMID 22186215.
- ↑ Cohen CA, Zagelbaum G, Gross D, Roussos C, Macklem PT (September 1982). "Clinical manifestations of inspiratory muscle fatigue". Am. J. Med. 73 (3): 308–16. PMID 6812417.
- ↑ Slutsky AS (December 1993). "Mechanical ventilation. American College of Chest Physicians' Consensus Conference". Chest. 104 (6): 1833–59. PMID 8252973.