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Ventilator Settings in Acute Care Environments

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Monitoring Technologies in Acute Care Environments

Abstract

Ventilator settings across acute care environments are quite similar, be it in the emergency department, intensive care unit, or operating room. They are based on a lung-protective strategy to limit barotrauma, volutrauma, atelectrauma, and biotrauma. The main settings are the ventilation mode (in volume or in pressure) and the modality (controlled, assisted, or spontaneous). The clinician must adjust respiratory parameters (which can differ depending on the mode and modality chosen), including tidal volume or inspiratory pressure, respiratory rate, positive end-expiratory pressure, inspiratory-to-expiratory ratio, inspiratory flow, inspiratory pause, or inspiratory trigger. Additionally, care must be paid to setting of respiratory alarms in order to avoid complications.

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References

  1. The ARDS Network. Ventilation with lower tidal volumes as compared with traditional tidal volumes for acute lung injury and the acute respiratory distress syndrome. N Engl J Med. 2000;342(18):1301ā€“8.

    ArticleĀ  Google ScholarĀ 

  2. Amato MB, Barbas CS, Medeiros DM, Magaldi RB, Schettino GP, Lorenzi-Filho G, et al. Effect of a protective-ventilation strategy on mortality in the acute respiratory distress syndrome. N Engl J Med. 1998;338(6):347ā€“54.

    ArticleĀ  PubMedĀ  CASĀ  Google ScholarĀ 

  3. Parker JC, Hernandez LA, Peevy KJ. Mechanisms of ventilator-induced lung injury. Crit Care Med. 1993;21(1):131ā€“43.

    ArticleĀ  PubMedĀ  CASĀ  Google ScholarĀ 

  4. Dreyfuss D, Soler P, Basset G, Saumon G. High inflation pressure pulmonary edema. Respective effects of high airway pressure, high tidal volume, and positive end-expiratory pressure. Am Rev Respir Dis. 1988;137(5):1159ā€“64.

    ArticleĀ  PubMedĀ  CASĀ  Google ScholarĀ 

  5. Muscedere JG, Mullen JB, Gan K, Slutsky AS. Tidal ventilation at low airway pressures can augment lung injury. Am J Respir Crit Care Med. 1994;149(5):1327ā€“34.

    ArticleĀ  PubMedĀ  CASĀ  Google ScholarĀ 

  6. Zhang H, Downey GP, Suter PM, Slutsky AS, Ranieri VM. Conventional mechanical ventilation is associated with bronchoalveolar lavage-induced activation of polymorphonuclear leukocytes: a possible mechanism to explain the systemic consequences of ventilator-induced lung injury in patients with ARDS. Anesthesiology. 2002;97(6):1426ā€“33.

    ArticleĀ  PubMedĀ  Google ScholarĀ 

  7. Jaber S, Jung B, Matecki S, Petrof BJ. Clinical review: ventilator-induced diaphragmatic dysfunction ā€“ human studies confirm animal model findings! Crit Care. 2011;15(2):206.

    ArticleĀ  PubMedĀ  Google ScholarĀ 

  8. Jaber S, Petrof BJ, Jung B, Chanques G, Berthet JP, Rabuel C, et al. Rapidly progressive diaphragmatic weakness and injury during mechanical ventilation in humans. Am J Respir Crit Care Med. 2011;183(3):364ā€“71.

    ArticleĀ  PubMedĀ  CASĀ  Google ScholarĀ 

  9. Curley G, Hayes M, Laffey JG. Can ā€˜permissiveā€™ hypercapnia modulate the severity of sepsis-induced ALI/ARDS? Crit Care. 2011;15(2):212.

    ArticleĀ  PubMedĀ  Google ScholarĀ 

  10. Hickling KG, Walsh J, Henderson S, Jackson R. Low mortality rate in adult respiratory distress syndrome using low-volume, pressure-limited ventilation with permissive hypercapnia: a prospective study. Crit Care Med. 1994;22(10):1568ā€“78.

    ArticleĀ  PubMedĀ  CASĀ  Google ScholarĀ 

  11. Tobin MJ. Advances in mechanical ventilation. N Engl J Med. 2001;344(26):1986ā€“96.

    ArticleĀ  PubMedĀ  CASĀ  Google ScholarĀ 

  12. Devaquet J, Jonson B, Niklason L, Si Larbi AG, Uttman L, Aboab J, et al. Effects of inspiratory pause on CO2 elimination and arterial PCO2 in acute lung injury. J Appl Physiol. 2008;105(6):1944ā€“9.

    ArticleĀ  PubMedĀ  Google ScholarĀ 

  13. Pelosi P, Bottino N, Chiumello D, Caironi P, Panigada M, Gamberoni C, et al. Sigh in supine and prone position during acute respiratory distress syndrome. Am J Respir Crit Care Med. 2003;167(4):521ā€“7.

    ArticleĀ  PubMedĀ  Google ScholarĀ 

  14. Romanoff ME. A sigh is not a sigh, as PEEP blows by. Anesthesiology. 2004;101(4):1047; author reply āˆ’8.

    ArticleĀ  PubMedĀ  Google ScholarĀ 

  15. Constantin JM, Futier E, Cherprenet AL, Chanques G, Guerin R, Cayot-Constantin S, et al. A recruitment maneuver increases oxygenation after intubation of hypoxemic intensive care unit patients: a randomized controlled study. Crit Care. 2010;14(2):R76.

    ArticleĀ  PubMedĀ  Google ScholarĀ 

  16. Banner M, Blanch P, Kirby R, Miller R. Respiratory care. In: Atlas of anesthesia, vol. 1. New York: Current Medicine; 2002.

    Google ScholarĀ 

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Correspondence to Samir Jaber MD, PhD .

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Coisel, Y., Jung, B., Jaber, S. (2014). Ventilator Settings in Acute Care Environments. In: Ehrenfeld, J., Cannesson, M. (eds) Monitoring Technologies in Acute Care Environments. Springer, New York, NY. https://doi.org/10.1007/978-1-4614-8557-5_23

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  • DOI: https://doi.org/10.1007/978-1-4614-8557-5_23

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  • Publisher Name: Springer, New York, NY

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  • Online ISBN: 978-1-4614-8557-5

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