Mechanical ventilation of the patient

doi:10.1017/CBO9780511544644.018

16 - Mechanical ventilation of the patient

Published online by Cambridge University Press: 13 August 2009

Edited by

Paul Wicker and

Brian Smith: Affiliation:
Edge Hill College of Higher Education, Liverpool
Paul Rawling: Affiliation:
Edge Hill College of Higher Education, Liverpool
Paul Wicker: Affiliation:
Edge Hill College of Higher Education, Liverpool
Chris Jones: Affiliation:
Edge Hill College of Higher Education, Liverpool

Book contents

Get access

Summary

Key learning points

To understand the indications for mechanical ventilation
To appreciate the differing regimes of ventilatory support and their indications
To be able to describe the patient safety aspects of mechanical ventilation
To be able to indicate differing approaches to weaning from mechanical ventilation

Introduction

Mechanical ventilation is sometimes used within recovery areas and is commonly used in the intensive care setting to artificially ventilate persons who are unable to breathe spontaneously at all or are unable to provide themselves with adequate spontaneous ventilation to guarantee satisfactory gas exchange.

Post operative patients may occasionally require a short time on mechanical ventilation until they can be safely extubated, whilst those in an intensive care setting often require a longer period of ventilation.

Mechanically ventilated patients may need to be transported to other departments within the hospital, for example, to receive a scan, or to a different hospital for various reasons. Operating department practitioners (ODPs) play an important role in maintaining the safety of these patients during transfer. So, whilst it is imperative for the intensive care nurse to have a thorough understanding of the principles and mechanics of mechanical ventilation, ODPs and theatre staff must familiarise themselves with these principles to ensure the safest care of their patients.

This chapter will examine issues surrounding mechanical ventilation and the care of patients who are recovering from surgery.

Mechanical ventilation is the artificial control of the breathing cycle by means of a machine (Ashurst, 1997).

Type: Chapter
Information: Core Topics in Operating Department Practice
Anaesthesia and Critical Care
, pp. 161 - 171

DOI: https://doi.org/10.1017/CBO9780511544644.018 [Opens in a new window]

Publisher: Cambridge University Press

Print publication year: 2007

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

Book purchase

Temporarily unavailable

References

Ashurst, S. (1997). Nursing care of the mechanically ventilated patient in intensive care: 1. British Journal of Nursing, 6(8), 447–54.Google Scholar

Barbas, C. S. V., Matos, G. F., Pincelli, M. P., et al. (2005). Mechanical ventilation in acute respiratory failure: recruitment and high positive end-expiratory pressure are necessary. Current Opinion in Critical Care, 11(1), 18–28.Google Scholar

Bronchard, L., Mancebo, J., Wysocki, M.et al. (1995). Non-invasive ventilation for acute exacerbations of COPD. New England Journal of Medicine, 333, 817–22.Google Scholar

Calfee, C. S. & Matthay, M. A. (2005). Recent advances in mechanical ventilation. The American Journal of Medicine, 118(6), 584–91.Google Scholar

Carroll, P. (1996). Getting your patient off a ventilator. RN, 59(6), 42–7.Google Scholar

Cooper, S. (2004). Methods to prevent ventilator-associated lung injury: a summary. Intensive and Critical Care Nursing, 20, 358–65.Google Scholar

Dreyfuss, D. & Saumon, G. (1998). Ventilator-induced lung injury: lessons from experimental studies. American Journal of Respiratory Critical Care Medicine, 157, 294–323.Google Scholar

Eltringham, R., Casey, W. & Durkin, M. (1998). Post-Operative Recovery and Pain Relief. London: Springer-Verlag.

Esteban, A., Anzueto, A., Alia, I.,et al. (2004). How is mechanical ventilation employed in the ICU? An international utilization review. American Journal of Respiratory and Critical Care Medicine, 161, 1450–8.Google Scholar

Esteban, A., Frutos-Vivar, F., Ferguson, N. D.,et al. (2004). Noninvasive positive-pressure ventilation for respiratory failure after extubation. New England Journal of Medicine, 350, 2452–60.Google Scholar

Goldhill, D. (2000). Clinical Guideline 2: Guidelines for weaning from a ventilator. Care of the Critically Ill, 16(2), 48–9.Google Scholar

Intensive Care Society. (2002). Guidelines for transfer of the critically ill patient. London: Intensive Care Society.

Juniper, M. (1999). Ventilator-associated pneumonia: risk factors, diagnosis and management. Care of the Critically Ill, 15(6), 198–201.Google Scholar

Lanken, P. (2001). The ICU Manual. Paul N. Lanken, C. William Hanson & Scott Manaker, eds. W. B. Saunders Company, p. 13.

Lindgreen, V. & Ames, N. (2005). Caring for patients on mechanical ventilation. American Journal of Nursing, 105(5), 50–60.Google Scholar

MacIntyre, N. R., Cook, D. J., Ely, E. W. Jr., et al. (2001). Evidence-based guidelines for weaning and discontinuing ventilatory support: a collective task force facilitated by the American College of Chest Physicians, the American Association for Respiratory Care and the American College of Critical Care Medicine. Chest, 120(6 Suppl), 3755–955.Google Scholar

Park, G. & Sladen, R. N. (2001). Top Tips in Critical Care. Park, G. & Sladen, R. N. eds. Miton Keynes: Greenwich Medical Media.

Patroniti, N.Foti, G., Manflo, A., et al. (2003). Head helmet versus face mask for non-invasive continuous positive airway pressure: a physiological study. Intensive Care Medicine, 29, 1680–7.Google Scholar

Ranien, V. M. & Zhang, H. (1999). Respiratory mechanics in acute respiratory distress syndrome: relevance to monitoring and therapy of ventilator induced lung injury. Current Opinion in Critical Care, 5, 17–20.Google Scholar

Shelly, M. & Nightingale, P. (1999). ABC of Intensive Care. M. Singer & I. Grant, eds. London: BMJ Books.

Slutsky, A. & Tremblay, L. (1999). Multiple system organ failure: is mechanical ventilation a contributing factor?American Journal of Respiratory Critical Care Medicine, 157, 1721–5.Google Scholar

Steinberg, J. M., Schiller, H. J., Halter, J. M.et al. (2004). Alveolar instability causes early ventilator–induced lung injury independent of neutrophils. American Journal of Respiratory Critical Care Medicine, 169, 57–63.Google Scholar

Tan, I. & Oh, T. (1997). I.C. Manual, 4th edn. Oh, T. E., ed., Heinemann: Butterworth.

Tonnelier, J. M.Prat, G., Nowak, E., et al. (2003). Non-invasive CPAP ventilation using a new helmet interface: a case-controlled prospective study. Intensive Care Medicine, 29(11), 2077–80.Google Scholar

Urden, L., Stacy, K., & Lough, M. (1998). Thelan's Critical Care Nursing Diagnosis and Management, 3rd edn., Mosby Inc.

Woodruff, D. (2003). Hospital Nursing – Protect your patient while he's receiving mechanical ventilation. Nursing, 32(7), 321–4.Google Scholar