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Chapter 3. Mechanical Ventilation

Gregory A Schmidt, MD, FCCP
DOI: 10.1378/critcare.21.3
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Sections

Objectives 
  • Review modes.

  • Examine physiology of ventilation.

  • Discuss the types of respiratory failure.

  • Introduce key ventilation concepts.

  • Review equation of motion.

  • Discuss VILI and VIDD.

  • Review autoPEEP.

  • Examine permissive hypercapnia.

  • Discuss the ventilator bundle.

Synopsis 

This chapter offers an approach in which two aspects of mechanical ventilation, oxygenation (largely determined by Fio2 and positive end-expiratory pressure [PEEP]) and ventilation (depending mostly on mode, rate, and tidal volume or set inspiratory pressure) are considered separately. Then the ventilator is used as a probe of the patient's respiratory system mechanical derangements, and ventilator settings are tailored to the patient's mechanical and gas exchange abnormalities. Modes of ventilation are analyzed and key ventilation concepts of ventilator-induced lung injury; ventilator-induced diaphragm dysfunction; autoPEEP; permissive hypercapnia; and the ventilator bundle are covered.

References

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