Anesthesia for patients requiring advanced ventilatory support.
The critically ill patient who requires anesthesia is frequently a concern for the anesthesiologist. In addition to having potential hemodynamic lability and coagulopathy, the critically ill patient frequently experiences profound respiratory failure. The approach to the patient requiring advanced ventilatory support requires an understanding of respiratory failure, the pathophysiology causing respiratory failure and hypoxia, the physiology of mechanical ventilation and the advanced modes of ventilation available in the intensive care unit (ICU). This article discusses the basic definitions of hypoxia and common pathologic states, reviews the physiology of mechanical ventilation and advanced forms of ventilation available in the ICU, and concludes with recommendations for the management of patients with severe respiratory failure when they are taken to the operating room.
Blum
James M
JM
Division of Critical Care Medicine, Department of Anesthesiology, University of Michigan Medical Center, University of Michigan Medical School, 1500 East Medical Center Drive, Ann Arbor, MI 48109, USA. jmblum@umich.edu
Blank
Ross
R
Rochlen
Lauryn R
LR
D000758:Anesthesia; D016638:Critical Illness / Q000628:therapy*; D013502:General Surgery; D006801:Humans; D008021:Life Support Systems; D010102:Oxygen Inhalation Therapy; D012121:Respiration, Artificial; D012131:Respiratory Insufficiency / Q000150:complications; D012143:Respiratory Physiological Phenomena; D009626:Terminology as Topic; D012122:Ventilators, Mechanical