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][3][4][5][6][7]

  • The three most common indications for mechanical ventilation:
    • Inadequate oxygenation
    • Inadequate ventilation
    • 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
  • 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

  1. Tung A (1997). "Indications for mechanical ventilation". Int Anesthesiol Clin. 35 (1): 1–17. PMID 9113518.
  2. 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.
  3. 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.
  4. 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.
  5. 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.
  6. 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.
  7. Slutsky AS (December 1993). "Mechanical ventilation. American College of Chest Physicians' Consensus Conference". Chest. 104 (6): 1833–59. PMID 8252973.

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