Mechanical Ventilation

• 1. Look at the two major groupings
• 2. Techniques
• 3. Patient Care Plans

• 1. Normal or Acute
• 2. Abnormal or Chronic

• i. Accidents
• ii. Chest Trauma
• iii. Drowning
• iv. ODs
• v. neuromuscular
• vi. renal failure
• vii. CHF
• viii. MI
• iv. All generally have normal lunch function/mechanics

• i. CB/E
• ii. Pts with obstructive or restrictive processes/fibrosis
• iii. Usually placed on ventilator respiratory failure.
• iv. Have abnormal lung mechanics
• v. May have abnormal drives.

Technique of hyerventilating a patient to avoid regional or global overdistention. Technique is implemented when concerned about barotrauma or the effects of an elevated MAP through the use of volume ventilation leading to high peak pressures.

• 1. Allow PaCO2 to rise greater than normal, 50-100 torr but no higher than 150.
• 2. pH to fall no lower than 7.20-7.25 in patients without cardiovascular disease or renal problems.
• 4. Patient should be sedated and paralyzed
• 5. Gradually allow PaCO2 to rise
• 6. Contraindicated in patients with elevated ICPs

Recommended that plateau pressure (Pplat) should not exceed 35 cm H2O results in barotrauma in healthy lungs. If the Pplat > 35 cm H2O candidate for hypercapnia.

• 1. PaCO2 50-100 not >150
• 2. pH not less than 7.20