Skip to main content

Mechanical Ventilation, Types, Indications, Complications of Mechanical Ventilation

Author: Kashif Rauf
Mechanical Ventilation
When the patient continues to deteriorate or fails to improve with other measures and oxygen therapy, he needs some respiratory support with mechanical ventilation. Mechanical ventilation improves C02 elimination (confirmed by performing ABG Test) and removes work of breathing, gives relief from exhaustion by giving rest to the respiratory muscles.

Types of Mechanical Ventilation:

Mechanical ventilation may be non-invasive or invasive.

1. Non- invasive mechanical ventilation
mechanical ventilation with mask
In non- invasive respiration is supported with a face mask or nasal mask so that, endotracheal intubation is avoided. The patient should be conscious, cooperative, be able to breathe spontaneously and cough effectively. This technique is commonly used in acute exacerbation of COPD and pneumonia.

2. Invasive mechanical ventilation
mechanical ventilation with endotracheal tube
In invasive mechanical ventilation endotracheal tube is passed. The patient may require full or partial support. In full Support, all respiration is controlled by a ventilator that does not allow spontaneous breaths. The patient is deeply sedated with short-acting IV anaesthetic agent and paralyzed with a muscle relaxant. In partial support ventilator helps and augment the patient’s own breaths; it does not require deep sedation and paralysis.

Indications of Mechanical Ventilation

Indications of mechanical ventilation are listed below
  • Respiratory failure not responding to medical treatment.
  • Head injury - controlled hyperventilation to reduce intracranial pressure.
  • Chest injury.
  • Severe pulmonary oedema

Weaning from Respiratory Support:

This is the process of progressively reducing and eventually removing all external ventilatory support and associated apparatus. If the apparatus is suddenly removed, the patient may be unable to breathe because of respiratory muscle weakness and residual decreased lung compliance.

Complications of Mechanical Ventilation:

  • Tube in one lung causes a collapse of the other lung.
  • Fall in cardiac output due to positive pressure in lung and thorax that reduces venous return.
  • Ventilator-induced lung injury such as barotraumas due to over-distension of alveoli leading to pneumomediastinum, subcutaneous emphysema and pneumothorax.
  • Nosocomial (hospital acquired) pneumonia.
  • Abdominal distension and ileus.

Modes of Mechanical Ventilation

  • Continuous positive pressure (CPAP) given by mask
Used in acute exacerbation of COPD, pulmonary oedema and the postoperative collapse of the lung. May be used with endotracheal intubation or tightly fitting face mask
  • Bilevel positive airway pressure (BiPAP)
  • Non- invasive intermittent positive pressure ventilation (NIPPV) given by mask
Used in acute exacerbation of COPD
  • Controlled mandatory ventilation (CMV)
Appropriate for initial control of patient with little respiratory drive
  • Synchronized intermittent mandatory ventilation (SIMV)
IT allows the patient to breathe spontaneously between the mandatory tidal volumes delivered by the ventilator.
  • Pressure support ventilation (PSV)
Spontaneous breaths are augmented by a preset level of positive pressure (positive pressure means above atmospheric pressure)
  • Positive end-expiratory pressure (PEEP)
The pressure is given throughout the expiration. Helps in re-expand collapse or edematous lung.


Popular posts from this blog

Human Parasites, Types of Parasites, and Classification

Parasite: A parasite is a living organism which gets nutrition and protection from another organism where it lives. Parasites enter into the human body through mouth, skin and genitalia. In this article, we will generally discuss the types and classification of parasites. It is important from an academic point of view. Those parasites are harmful, which derives their nutrition and other benefits from the host and host get nothing in return but suffers from some injury. Types of Parasites Ecto-parasite: An ectoparasite lives outside on the surface of the body of the host. Endo-parasite: An endo-parasite lives inside the body of the host, it lives in the blood, tissues, body cavities, digestive tract or other organs. Temporary parasite: A temporary parasite visits its host for a short period of time. Permanent parasite: Permanent parasite lives its whole life in the host. Facultative parasite: A facultative parasite can live both independently and dependently. It lives in the

How to taper off, wean off beta blocker, atenolol, Propranolol, Metoprolol

Beta blockers include, atenolol (Tenormin), propranolol (Inderal ) and metoprolol (Lopressor) and are used to treat high blood pressure, certain cardiac problems, migraine and few other conditions. People usually take atenolol, propranolol or metoprolol for many years as a treatment of high blood pressure or after having an episode of heart attack . Sometimes, it becomes necessary to withdraw these beta blockers due to their potential side effects that trouble the patients or sometimes doctor wants to change the drug and shift the patient to some other anti-hypertensive medicine. No matter whatever the cause is, whenever, a patient who has been using a beta blocker for a long period of time, and he needs to be stopped from further usage of that beta blocker, must not stop taking it. One should taper off the dose of a beta blocker. Now a question arises how to wean off or taper off a beta blocker? The method of tapering off beta blocker varies from individual to individual. Allow you

Difficulty in standing up from a sitting or squatting position, Causes & Solution

People who feel it difficult to stand up from a sitting or squatting position may have problem in one or more of the following structures. 1. Knee joint 2. Muscles of legs, thighs or buttock 3. Muscles of arms 4. Cerebellum Let’s now explain one by one, what kind of problems in above structures may cause difficulty in standing up from a sitting or squatting position. 1. How do problems in knee joints lead to difficulty in standing up? Knee joint is one of the primary and most affected joint that takes part in standing up. Other joints that take part are hip, ankle, knee, elbow, wrist and shoulder joint. Knee joint gets the most strain , and also knee joint is comparatively less supported. That’s why usually it’s the knee joint that starts to cry first because of arthritis. Knee joint arthritis causes long term knee pain , that makes the movement difficult at knee joint. Arthritis also makes the knee joint stiffer and slower and its range of motion also decreases. All these affects coll