Basic Invasive Mechanical Ventilation

Benjamin D. Singer, MD; Thomas C. Corbridge, MD

Disclosures

South Med J. 2009;102(12):1238-1245. 

In This Article

Abstract and Introduction

Abstract

Invasive mechanical ventilation is a lifesaving intervention for patients with respiratory failure. The most commonly used modes of mechanical ventilation are assist-control, synchronized intermittent mandatory ventilation, and pressure support ventilation. When employed as a diagnostic tool, the ventilator provides data on the static compliance of the respiratory system and airway resistance. The clinical scenario and the data obtained from the ventilator allow the clinician to provide effective and safe invasive mechanical ventilation through manipulation of the ventilator settings. While life-sustaining in many circumstances, mechanical ventilation may also be toxic and should be withdrawn when clinically appropriate.

Introduction

The need for mechanical ventilation is a frequent reason for admission to an intensive care unit. Mechanical ventilation following endotracheal intubation is often used to improve pulmonary gas exchange during acute hypoxemic or hypercapnic respiratory failure with respiratory acidosis.[1] Mechanical ventilation also redistributes blood flow from working respiratory muscles to other vital organs and is therefore a useful adjunct in the management of shock from any cause.

This article will review basic invasive mechanical ventilator modes and settings, the use of the ventilator as a diagnostic tool, and complications of mechanical ventilation. Weaning and extubation will also be discussed.

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