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The indications of the mechanical ventilation is as follows:<ref name="pmid9113518">{{cite journal |vauthors=Tung A |title=Indications for mechanical ventilation |journal=Int Anesthesiol Clin |volume=35 |issue=1 |pages=1–17 |year=1997 |pmid=9113518 |doi= |url=}}</ref><ref name="pmid26902369">{{cite journal |vauthors=Kreppein U, Litterst P, Westhoff M |title=[Hypercapnic respiratory failure. Pathophysiology, indications for mechanical ventilation and management] |language=German |journal=Med Klin Intensivmed Notfmed |volume=111 |issue=3 |pages=196–201 |year=2016 |pmid=26902369 |doi=10.1007/s00063-016-0143-2 |url=}}</ref>
The indications of the mechanical ventilation is as follows:<ref name="pmid9113518">{{cite journal |vauthors=Tung A |title=Indications for mechanical ventilation |journal=Int Anesthesiol Clin |volume=35 |issue=1 |pages=1–17 |year=1997 |pmid=9113518 |doi= |url=}}</ref><ref name="pmid26902369">{{cite journal |vauthors=Kreppein U, Litterst P, Westhoff M |title=[Hypercapnic respiratory failure. Pathophysiology, indications for mechanical ventilation and management] |language=German |journal=Med Klin Intensivmed Notfmed |volume=111 |issue=3 |pages=196–201 |year=2016 |pmid=26902369 |doi=10.1007/s00063-016-0143-2 |url=}}</ref>


Mechanical ventilation is indicated when the patient's spontaneous [[Breath|ventilation]] is inadequate to maintain life. It is also indicated as prophylaxis for the imminent collapse of other physiologic functions, or ineffective gas exchange in the lungs. Because mechanical ventilation only serves to provide assistance for breathing and does not cure a disease, the patient's underlying condition should be correctable and should resolve over time. In addition, other factors must be taken into consideration because mechanical ventilation is not without its complications.
*The three most common indications for mechanical ventilation are
1) inadequate oxygenation
2) inadequate ventilation  
3) inability to protect the airway


Common indications for mechanical ventilation include the following:
Other indications for mechanical ventilation include the following:
* Bradypnea  
* Bradypnea  
* Tachypnea (respiratory rate >30 breaths per minute)
* Apnea with respiratory arrest including cases from [[intoxication]]
* Apnea with respiratory arrest including cases from [[intoxication]]
* Acute lung injury and the acute respiratory distress syndrome
* Acute respiratory distress syndrome
* Tachypnea (respiratory rate >30 breaths per minute)
* Vital capacity less than 15 mL/kg
* Vital capacity less than 15 mL/kg
* Minute ventilation greater than 10 L/min
* Minute ventilation greater than 10 L/min
* <small>Reduced respiratory drive</small>
* Reduced respiratory drive
* <small>Chest wall abnormalities</small>
* Abnormalities of the Chest wall
* <small>Respiratory muscle fatigue</small>
* Respiratory muscle fatigue
* <small>Intrapulmonary shunt</small>
* Intrapulmonary shunt
* <small>Ventilation-perfusion mismatch</small>
* V/Q mismatch(ventilation-perfusion)
* <small>Decreased FRC</small>
* Decreased Functional Residual Capacity
* 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
* 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 DO <sub>2</sub>) with 100% oxygenation of greater than 450 mm Hg
* Alveolar-arterial gradient of oxygen tension (A-a DO <sub>2</sub>) with 100% oxygenation of greater than 450 mm Hg
* Clinical deterioration
* Respiratory muscle fatigue
* Coma
* Coma
* Hypotension due to sepsis, shock, CHF
* Hypotension due to sepsis, shock, CHF
* Acute partial pressure of carbon dioxide (PaCO <sub>2</sub>) greater than 50 mm Hg with an arterial pH less than 7.25
* Acute partial pressure of carbon dioxide (PaCO <sub>2</sub>) greater than 50 mm Hg with an arterial pH less than 7.25
* Acute lung injury (including [[acute respiratory distress syndrome|ARDS]], trauma)
* [[Chronic obstructive pulmonary disease]] ([[COPD]])
* [[Chronic obstructive pulmonary disease]] ([[COPD]])
* Acute [[respiratory acidosis]] with  
* Acute [[respiratory acidosis]] with  

Revision as of 13:11, 23 February 2018

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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
  • 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.

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