Ventilator management in critical illness

Research output: Chapter in Book/Report/Conference proceedingChapter

Abstract

Respiratory failure remains one of the leading causes of maternal mortality. This chapter reviews the general principles of ventilator management in the gravid patient with respiratory failure. It elaborates early identification and management of respiratory compromise with the most recent advances in mechanical support. The chapter discusses ventilator modes such as controlled mechanical ventilation (CMV), synchronized intermittent mandatory ventilation (SIMV), pressure support ventilation (PSV), and pressure-regulated volume control (PRVC) modes. Concerns about maternal hypercapnia on the developing fetus are discussed. Modern ventilatory management includes a strategy of small tidal volumes with adequate levels of positive end expiratory pressure (PEEP). Most evidence recommends that in between spontaneous breathing trials, the patient should receive comfortable stable ventilatory support in order to avoid muscle fatigue. Factors that cause an increase in ventilatory requirements include increased CO2production, increased dead space ventilation, and an inappropriately elevated respiratory drive.

Original languageEnglish (US)
Title of host publicationCritical Care Obstetrics
Publisherwiley
Pages215-248
Number of pages34
ISBN (Electronic)9781119129400
ISBN (Print)9781119129370
DOIs
StatePublished - Jan 1 2018

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Keywords

  • Controlled mechanical ventilation
  • Critical illness
  • Maternal hypercapnia
  • Peep
  • Pressure support ventilation
  • Synchronized intermittent mandatory ventilation
  • Ventilator management

ASJC Scopus subject areas

  • Medicine(all)

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