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Harrison's Principles of Internal Medicine, 18e
| Part 12. Critical Care Medicine > Section 1. Respiratory Critical Care > |
Chapter 269. Mechanical Ventilatory Support
Sections: Mechanical Ventilatory Support, General Support during Ventilation, Further Readings.
Topics Discussed: mechanical ventilation.
Excerpt:"Mechanical ventilation is a therapeutic method that is used to assist or replace spontaneous breathing. The primary indication for initiation of mechanical ventilation is respiratory failure, of which there are two basic types: hypoxemic respiratory failure, which is present when arterial O2 saturation (SaO2) <90% occurs despite an increased inspired O2 fraction, and hypercarbic respiratory failure, which is characterized by arterial PCO2 values >50 mmHg. When it is chronic, neither of the two types is obligatorily treated with mechanical ventilation, but when acute, mechanical ventilation may be lifesaving.The most common reasons for instituting mechanical ventilation are acute respiratory failure with hypoxemia (acute respiratory distress syndrome, heart failure with pulmonary edema, pneumonia, sepsis, complications of surgery and trauma), which accounts for ~65% of all ventilated cases, followed by causes of hypercarbic ventilatory failure such as coma (15%), exacerbations of chronic obstructive pulmonary disease (13%), and neuromuscular diseases (5%). The primary objectives of mechanical ventilation are to decrease the work of breathing, thus avoiding respiratory muscle fatigue, and to..."
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