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4.7 - Mechanical Ventilation: Initiation, Maintenance and Weaning

from Section 4 - Therapeutic Interventions and Organ Support

Published online by Cambridge University Press:  27 July 2023

By
Ranil Soysa  and
Kate Tatham
Edited by
Ned Gilbert-Kawai ,
Debashish Dutta  and
Carl Waldmann
Ned Gilbert-Kawai
Affiliation:
The Royal Liverpool Hospital
Debashish Dutta
Affiliation:
Princess Alexandra Hospital NHS Trust, Harlow
Carl Waldmann
Affiliation:
Royal Berkshire Hospital, Reading
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Summary

Key Learning Points

  1. 1. Indications for initiating mechanical ventilation are multifactorial and patient-specific.

  2. 2. Various modes of ventilation are available and can be modified, depending on individual patient requirements.

  3. 3. A systems-based approach to patient care during mechanical ventilation may reduce the risk of associated complications.

  4. 4. Application of therapies such as proning may improve outcome.

  5. 5. Weaning from mechanical ventilation should be a team-based decision, and use of a structured protocol is recommended.

Keywords

mechanical ventilationweaningproningSIMVAPRV
Type
Chapter
Information
Intensive Care Medicine
The Essential Guide
 , pp. 495 - 499
Publisher: Cambridge University Press
Print publication year: 2021

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References

References and Further Reading

Fan, E, Del Sorbo, L, Goligher, EC, et al. An Official American Thoracic Society/European Society of Intensive Care Medicine/Society of Critical Care Medicine Clinical Practice Guideline: mechanical ventilation in adult patients with acute respiratory distress syndrome. Am J Respir Crit Care Med 2017;195:1253–63.CrossRefGoogle ScholarPubMed
Girard, TD, Alhazzani, W, Kress, JP, et al. An Official American Thoracic Society/American College of Chest Physicians Clinical Practice Guideline: liberation from mechanical ventilation in critically ill adults rehabilitation protocols, ventilator liberation protocols, and cuff leak tests. Am J Respir Crit Care Med 2017;195:120–33.CrossRefGoogle ScholarPubMed
Goligher, EC, Douflé, G, Fan, E. Update in mechanical ventilation, sedation and outcomes 2014. Am J Respir Crit Care Med 2015;191:1367–73.CrossRefGoogle ScholarPubMed
Guerin, CJ, Reignier, J, Richard, J-C, et al. Prone positioning in severe acute respiratory distress syndrome. N Engl J Med 2013;368:2159–68.CrossRefGoogle ScholarPubMed
Slutsky, AS, Ranieri, VM. Ventilator-induced lung injury N Engl J Med 2013;369:2126–36.CrossRefGoogle ScholarPubMed

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