What is ventilator management?
Intubation is a procedure performed when the patient is unable to breathe by themselves. It may be a life-saving procedure in the emergency room (ER) or planned during the surgery when the patient is under general anesthesia.
The doctor inserts a tube through the nose or mouth into the throat and trachea (windpipe). The tube facilitates air entry into and out of the lungs. The tube is connected to a machine called a ventilator that pumps air containing an increased concentration of oxygen compared with atmospheric air. The machine then helps in exhaling air containing carbon dioxide (CO2).
The ventilator maintains normal oxygen and CO2 levels in the body. This is called mechanical ventilation. During mechanical ventilation, cardiac function, blood pressure and oxygen saturation/levels in the body are monitored continuously.
What are the types of ventilator management?
Most ventilators can be set to apply a custom amount of air based on the individual patient’s lungs and breathing function. This is called delivered tidal volume (the total volume of air that is inspired and expired in one cycle of breathing/respiration), and a respiratory therapist can adjust the delivered tidal volume . Ventilators deliver air via two basic settings:
- Control mode: In a control mode, the ventilator delivers a preset tidal volume once it is triggered irrespective of patient’s effort.
- Support mode: In a support mode, the ventilator provides assistance during inspiration with the help of an assist pressure. The ventilator detects inspiration by the patient and supplies an assist pressure during inspiration. The assist pressure is terminated when it detects expiration. The support mode requires the patient to have an adequate respiratory drive.
What are the methods of ventilatory support?
There are six major types of ventilator support:
- Continuous mandatory ventilation: Breaths are delivered at preset intervals, irrespective of the patient’s effort. This mode is usually used in patients who are paralyzed with no respiratory effort of their own. It can increase the breathing rate if respiratory effort is present; hence, it is not be used in patients with adequate respiratory drive.
- Assist-control ventilation: The ventilator delivers a preset number of breaths. This is used in co-ordination with the patient’s irregular spontaneous attempts at breathing.
- Intermittent mandatory ventilation (IMV): The ventilator delivers breaths at preset intervals, and spontaneous breathing occurs between the ventilator-administered breaths.
- Synchronous IMV: The ventilator delivers preset breaths in coordination with the respiratory effort of the patient. Spontaneous breathing occurs between the ventilator breaths. Synchronization between preset mandatory breaths with the patient’s spontaneous breaths reduces the risk of ventilator-related trauma to the chest.
- Pressure support ventilation: This type of ventilation is for people who are able to breathe some on their own. It reduces the risk of ventilator-related trauma to the chest and the effort of breathing. The airway pressure support is maintained till the patient's inspiratory flow drops. There is better patient comfort, reduced risk to the heart, reduced risk to the chest and better gas distribution.
- Noninvasive ventilation: Mechanical ventilatory support is provided through a mask instead of a tube. This is common in emergency departments. It is used in patients with mild-to-moderate respiratory failure, and the patient should be alert.
Latest Lungs News
Daily Health News
When is mechanical ventilation done?
The main purpose of mechanical ventilation is to protect the airway and manage respiratory failure. Patients with respiratory failure in the emergency room are usually clinically diagnosed. The decision to intubate and mechanically ventilate or use noninvasive ventilation support is based on clinical assessment by the physician, without delay for laboratory results.
What are the complications of mechanical ventilation?
Pulmonary (lung) complications
- Barotrauma (damage to the lungs due to pressure differences) may result in the following:
- Pneumomediastinum (air in the space between the two lungs)
- Pneumoperitoneum (presence of air in the abdomen)
- Pneumothorax (air in the space between the lungs and chest wall)
- Infection of the lungs
- Atelectasis (collapse of the lungs)
Cardiovascular (heart and blood vessels) complications
The heart and major blood vessels in the chest cavity are subjected to the increased pressure from mechanical ventilation. This may decrease cardiac function, leading to ischemia (decreased oxygenation in the body).
Health Solutions From Our Sponsors
Top Strategies for Ventilator Management Related Articles
Coma is the inability to waken or react to the surrounding environment. The Glasgow Coma Scale is frequently used to measure the depth of coma. Causes of coma include trauma, bleeding, edema, lack of oxygen, poisoning, or hypoglycemia. Prognosis for a patient in a coma depends on the cause of the coma.
Coronavirus COVID-19 Prevention: Test Your Medical IQWhat's really the best way to prevent the spread of new coronavirus COVID-19? Should wear a mask or not? Take this quiz to find out!
Coronavirus COVID-19 (SARS-CoV-2): The Latest News, Updates, and InformationSee the latest news updates and information on the Coronavirus COVID-19 outbreak. Learn about symptoms, prevention, possible treatments, quarantine, isolation, social distancing, self-isolation and more.
COVID-19 (Coronavirus) Prevention TipsCOVID-19 is a novel coronavirus that spreads from person to person via infected respiratory droplets. The main symptoms of COVID-19 infection include cough, fever, and shortness of breath. Occasionally, people infected with COVID-19 may experience diarrhea, a sore throat, a runny or stuffy nose, or aches and pains. Avoiding contact with infected people, social distancing, not touching your face, frequent hand washing, cleaning, and disinfecting of frequently touched surfaces can help to reduce your risk of contracting the 2019 novel coronavirus.
COVID-19 vs. AllergiesThough there is some overlap in allergy and COVID-19 signs and symptoms there are also significant differences. Symptoms that they have in common include headache, fatigue, tiredness, shortness of breath, wheezing, and sore throat. Fever does not occur with allergies but is one of the defining symptoms of COVID-19 infections.
COVID-19 vs. Flu vs. ColdWhen you're feeling sick, it can be difficult to distinguish the symptoms of a COVID-19 infection from the symptoms of the common cold or the flu (influenza). While fever is common with the flu and COVID-19, sneezing is typically only associated with colds. Though sore throats are typical with colds, they are uncommon with COVID-19 infections and the flu.
What Are the Different Types of Mechanical Ventilation?Mechanical ventilation is a treatment to help a person breathe when they find it difficult or are unable to breathe on their own. A mechanical ventilator pushes airflow into the patient’s lungs. Mechanical ventilation is part of the arsenal of supportive care clinicians use for COVID-19 coronavirus disease patients with the most severe lung symptoms.
What Are the Types of Noninvasive Ventilation?A ventilator is a machine that helps in delivering oxygen to your lungs. It is used to assist with breathing when you cannot breathe on your own. There are two types of ventilation includes invasive ventilation and noninvasive ventilation.
What Drugs May Fight COVID-19? Drug Trials, Treatments, VaccinesWhat drugs could help fight coronavirus COVID-19? Clinical studies are ongoing for antiviral drugs like hydroxychloroquine, chloroquine remdesivir, lopinavir and favipiravir, as well as COVID-19 vaccines. Learn why anti-flu respiratory drugs and home remedies may prove useful to treat or prevent serious coronavirus infections.
What Is Bag Valve Mask Ventilation (BVM) Used For?Bag-valve-mask (BVM) or the Ambu bag is a self-inflating bag used to provide ventilation to the person not breathing normally. BVM ventilation is a critical skill for emergency providers. BVM ventilation is a technique that restores breathing in patients who are not spontaneously breathing. BVM ventilation is indicated in the respiratory (lung) failure, failed intubation (insertion of an artificial ventilation tube into the trachea), patients undergoing anesthesia for elective surgery, and apnea (slowed or stopped breathing).
What Is Barotrauma in Mechanical Ventilation?Barotrauma is a condition in which the alveoli (air sacs of the lungs) rupture with a subsequent entry of air into the surrounding extra alveolar space. Barotrauma mainly occurs either due to the rupture of the air sacs (alveolus) of lungs or a direct injury. Alveolar rupture can be either ventilator-related or disease-related. Ventilator-related causes include Positive pressure ventilation and Elevated pressure. Disease-related causes include asthma, chronic obstructive pulmonary disease (COPD), chronic interstitial lung disease, and acute respiratory distress syndrome.
Who Needs Mechanical Ventilation?Mechanical ventilation is a treatment to help a person breathe when they find it difficult or are unable to breathe on their own. Mechanical ventilation is part of the arsenal of supportive care clinicians use for COVID-19 coronavirus disease patients with the most severe lung symptoms. Public health experts fear the coronavirus pandemic will cause a shortage of mechanical ventilation machines in the U.S.
COVID-19 (Coronavirus, 2019-nCoV)Infection with COVID-19 (2019 novel coronavirus, 2019-nCoV) causes respiratory problems in humans. Transmission of COVID-19 occurs mainly through contact with respiratory sections from an infected person, however, fecal contamination may also spread the virus. Symptoms start off flu-like and progress to coughing, fever, shortness of breath, shaking chills, headache, loss of sense of taste and/or smell, muscle pain, and sore throat. Treatment focuses on supportive care and symptom relief.
Coronavirus COVID-19 (SARS-CoV-2) Pandemic Outbreak: What You Need to KnowA new strain of coronavirus (COVID-19, SARS-CoV-2) was reported from Wuhan, China in December, 2019. This outbreak of respiratory flu-like symptoms has quickly spread resulting in a worldwide pandemic. Learn about symptoms, treatment, prevention and vaccine efforts.
Novel Coronavirus (COVID-19) Prevention: Frequently Asked QuestionsWhy is coronavirus considered dangerous? What are symptoms you should look for? Take this quiz to learn how to protect yourself.