What are the indications for mechanical ventilation?

Updated: Sep 15, 2020
  • Author: Christopher D Jackson, MD; Chief Editor: Zab Mosenifar, MD, FACP, FCCP  more...
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Common indications for mechanical ventilation include the following:

  • Bradypnea or apnea with respiratory arrest [2, 3]

  • Acute lung injury and the acute respiratory distress syndrome

  • Tachypnea (respiratory rate >30 breaths per minute)

  • Vital capacity less than 15 mL/kg

  • Minute ventilation greater than 10 L/min

  • Arterial partial pressure of oxygen (PaO2) with a supplemental fraction of inspired oxygen (FIO2) of less than 55 mm Hg

  • Alveolar-arterial gradient of oxygen tension (A-a DO2) with 100% oxygenation of greater than 450 mm Hg

  • Clinical deterioration

  • Respiratory muscle fatigue

  • Obtundation or coma

  • Hypotension

  • Acute partial pressure of carbon dioxide (PaCO2) greater than 50 mm Hg with an arterial pH less than 7.25

  • Neuromuscular disease

The trend of these values should influence clinical judgment. Increasing severity of illness should prompt the clinician to consider starting mechanical ventilation.

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