Mechanical ventilation (main): Difference between revisions

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==Modes==
==Background==
===CPAP===
*Intubation and ventilation typically required for [[respiratory failure]] or airway protection/severe [[altered mental status]]
* needs spont breathing pt
* not for fatiguing pt
* no back up rate


===CONTROL MODE===
===Categories of [[respiratory failure|Respiratory Failure]]===
* only in OR
*Type 1 - [[Hypoxemia]]
* machine initiates and delivers breath
*Type 2 - [[hypercapnia|Hypercarbia]]
* fixed rate and TV
*Type 3 - Perioperative
*Type 4 - [[Shock]]


===ASSIST CONTROL (AC)===
==Patient Positioning<ref>Greenwood J. Good Lung UP or DOWN? Maneuvers to Improve Oxygenation in Acute Respiratory Failure. Updated 7/15/2014. https://umem.org/educational_pearls/2464/.</ref>==
* preset rate and TV
*HOB elevation > 30 degrees
* pt able to trigger additional breaths
*Reverse trendelenberg at 30 degrees in obese hypoventilaters
 
*Lateral decubitus for severe unilateral lung disease
===SYNCH INTERM MANDATORY VENT (SIMV)===
**'''G'''ood lung to '''G'''round generally
* preset rate and TV synch to pt effort
**Good lung UP in these exceptions:
* for each additional breath triggered by pt- vent delivers variable TV depending on pt effort and condition of lung
***Massive [[hemoptysis]] - prevent blood into dependent, good lung
* because of pt effort- not recommended for tired or septic pt
***Large [[abscess]] - pus fills up dependent lung
 
***Unilateral [[emphysema]] - prevent hyperinflation
===PRESSURE SUPP0RT===
* use with SIMV or PEEP- not AC
* preset boost during inspiration of spont gen breath
 
==GENERAL==
RR X TV =


==See Also==
==See Also==
[[Vent (General)]]
{{Mechanical ventilation pages}}
 
[[Vent (Initial - Changes)]]
 
[[Vent (Weaning)]]
 
[[Ventilation (Non-Invasive)]]
 
[[Ventilator Management]]


==References==
<references/>


[[Category:Airway/Resus]]
[[Category:Critical Care]]
[[Category:Pulm]]
[[Category:Pulmonary]]

Revision as of 15:35, 27 September 2019

Background

Categories of Respiratory Failure

Patient Positioning[1]

  • HOB elevation > 30 degrees
  • Reverse trendelenberg at 30 degrees in obese hypoventilaters
  • Lateral decubitus for severe unilateral lung disease
    • Good lung to Ground generally
    • Good lung UP in these exceptions:
      • Massive hemoptysis - prevent blood into dependent, good lung
      • Large abscess - pus fills up dependent lung
      • Unilateral emphysema - prevent hyperinflation

See Also

Mechanical Ventilation Pages

References

  1. Greenwood J. Good Lung UP or DOWN? Maneuvers to Improve Oxygenation in Acute Respiratory Failure. Updated 7/15/2014. https://umem.org/educational_pearls/2464/.