Page 247 - Clinical Application of Mechanical Ventilation

Initiation of Mechanical Ventilation 213

I:E ratio medical futility
impending ventilatory failure P/F ratio
maximum inspiratory pressure prophylactic ventilatory support
(MIP)

Learning Objectives

After studying this chapter and completing the review questions, the learner
should be able to:

Outline the goals of mechanical ventilation.
Provide clinical signs and examples to differentiate the four primary indica-
tions for mechanical ventilation.
List the contraindications for mechanical ventilation.
Provide the suggested initial ventilator settings for mode, frequency, tidal
volume, pressure support, FO , PEEP, I:E ratio, and flow pattern.
2
I
Provide the suggested initial ventilator alarm settings for low volume, high/
low pressures, apnea, high frequency, and high/low FO .
I
2
Name the hazards and complications of mechanical ventilation.

INTRODUCTION

This chapter covers the indications, contraindications, and strategies for the
initiation of mechanical ventilation. Once a decision is made to implement
mechanical ventilation, the initial settings on the ventilator must be made using a
systematic approach. It is important to remember that these initial settings are
subject to change according to the changing patient condition. Frequent monitor-
ing of the patient is necessary to use the ventilator properly and to improve the
patient outcome.

GOALS OF MECHANICAL VENTILATION

Mechanical ventilation alone does not treat or reverse the underlying pathology
leading to the need for ventilator support. Rather, it is applied as one of the support
systems until the reversal of the pathological condition, so that the patient may
then become weaned from mechanical ventilation. Table 8-1 outlines the five main
goals of mechanical ventilation (Tobin, 1994).

Copyright 2013 Cengage Learning. All Rights Reserved. May not be copied, scanned, or duplicated, in whole or in part. Due to electronic rights, some third party content may be suppressed from the eBook and/or eChapter(s).
Editorial review has deemed that any suppressed content does not materially affect the overall learning experience. Cengage Learning reserves the right to remove additional content at any time if subsequent rights restrictions require it.