Ventilator Management in Critical Illness

This chapter reviews the general principles of ventilatory management in the gravid patient with respiratory failure. It presents early identification and management of respiratory compromise with the most recent advances in mechanical support. All tissues require oxygen for the combustion of organic compounds to fuel cellular metabolism. Oxygen delivery depends on oxygenation of blood in the lungs, the oxygen-carrying capacity of the blood, and the cardiac output. Arterial oxygen saturation can be assessed continuously and noninvasively by pulse oximetry. Hypoxemia is a major threat to normal organ function. Therefore, the main goal of therapy is to reverse and/or prevent tissue hypoxia, to guarantee adequate oxygen delivery to tissues. Underfeeding has several adverse effects on the respiratory system. These adverse effects can interfere with weaning. Patients with limited cardiac reserve may frequently fail attempts to withdraw mechanical ventilation secondary to heart failure and subsequent hydrostatic pulmonary edema.