Preventing the Need for Mechanical Ventilation

Abstract

Because mechanical ventilation carries high risks, critically ill patients should not receive this support if other intensive support can suffice. This can usually be done with trained persons and proper equipment, in patients who can breathe spontaneously and adequately to maintain carbon dioxide homeostasis. Important factors are good diagnosis and management, drug, fluid, and electrolyte therapy, appropriate artificial airway if needed, oxygen therapy, bronchial hygiene, cardio-vascular monitoring, use of CPAP if necessary, serial blood gas monitoring via indwelling lines, and monitoring of ventilation values. Coordination of efforts of physicians, nurses, respiratory therapists, and others, with priorities for each critically ill patient, can prevent the need for mechanical ventilation in many patients.