Techniques for ventilating patients with obstructive pulmonary disease.
In patients with obstructive lung disease, a strategy of mechanical ventilation that prolongs expiratory time and limits lung hyperinflation can decrease barotrauma. To prolong expiratory time, decrease minute ventilation and inspiratory time. Side effects of this strategy--high peak pressures and hypercapnia--are generally well tolerated. Additional goals for COPD patients include resting and strengthening respiratory muscles and decreasing load on the respiratory system. Short-acting benzodiazepines and morphine are effective for sedation and analgesia. Paralytic agents should be considered only if adequate control of the patient's cardiopulmonary status cannot be achieved by sedation alone.
Corbridge
T C
TC
Adult Special Care Unit, National Jewish Center for Immunology and Respiratory Medicine, Denver, USA.
Hall
J B
JB
D001469:Barotrauma / Q000209:etiology / Q000517:prevention & control*; D006801:Humans; D008173:Lung Diseases, Obstructive / Q000503:physiopathology / Q000628:therapy*; D055370:Lung Injury; D012121:Respiration, Artificial / Q000009:adverse effects / Q000379:methods*; D015300:Ventilator Weaning