Placing the Patient on the Ventilator

Abstract

Initiation of mechanical ventilation can lead to a decrease in the cardiac output and hypotension, especially in the intravascularly depleted patient. The mode, tidal volume, respiratory rate, PEEP, inspiratory time/I:E ratio, and fraction of inspired oxygen should all be selected. Low tidal volume ventilation and targeting low pressures on the ventilator have been shown to improve outcomes for patients with and without acute respiratory distress syndrome (ARDS) alike. Once initial settings have been selected, the patient requires close monitoring for hemodynamic deterioration and to ensure that the selected settings are appropriate.