Doctor insights on:
Critical Care Mechanical Ventilation With Oxygen
Simply : Intubation is placement of a tube in the trachea (wind pipe), mechanical ventilation is the process by which a patient receives oxygen using artificial means (a ventilator). Almost always, intubation is followed by mechanical ventilation and mechanical ventilation is performed most times after intubation. ...Read more
Artificial respiratn: Simply put 'ventilating' or breathing for the patient 'mechanically' . These machines are getting more and more sophisticated and have a lot of settable and measurable data points. ...Read more
Many possible: Not just peep-peak and mean pressures also must be considered. High pressure can indicate inappropriately high volumes, leading to volutrauma/ventilator associated lung injury. Increased intrathoracic pressures can impair heart function (decrease preload), impair kidney function (decrease renal blood flow), and contribute to higher intracranial & intra-abdominal pressures. ...Read more
Why consider a tracheostomy if anticipated prolonged ventilatory support >2 wks? Why not continue mechanical ventilation? how is nutrition addressed?
Comfort: Tracheostomy is more comfortable for patient and may allow better pulmonary clearing, and should be considered if prolonged vent necessary . Feeding may be via IV of via soft tube through nasal passage down into stomach or small bowel or can also place feeding tube percutaneously into stomach or small bowel through abdominal wall. Nutrition key to weaning off vent. ...Read more
It happens: Pneumonia, heart failure, stroke, & serious injury are some of the more common reasons; it's important to consider the goals of care & realistic expectations. Patients/family/power of attorney should make it clear what level of support they feel is acceptable. It's ok to make comfort a priority & say "no" to the ventilator. It's also ok to say "yes". Best to discuss this before the crisis. ...Read more
Indefinitely: Until a ventilator is available or the person is breathing on their own. ...Read more
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