Editing Breathing (section)

== '''Ventilation''' ==

*
* Allows control of all factors to suit patient's needs, including oxygen 100% and adjustment of RR, TV and frequency
* SIMV - synchronised intermittent mandatory ventilation
** Preserves some of the patient's respiratory muscle activity by synchronising ventilation around the patient's own respiratory effort
* PEEP
** High PEEP causes decreased venous return and a fall in CO, which may be very severe if the patient is hypovolaemic
** High PEEP can cause barotrauma
** High PEEP plus high oxygen can promote the toxic effects of oxygen - generally don't go above 80% with high PEEP
* Highest level of respiratory support is basically PCIRV (pressure-controlled inverse ratio ventilation), FiO2 > 0.8, PEEP>10cm H2O, and permissive hypercarbia. The only other things to do from here are to increase FiO2 to 100% and pronate the patient. After that you will need to put them on cardiopulmonary bypass.
* '''Weaning'''
** Requires:
*** Original cause of resp failure has been treated
*** Sedative drugs low enough not to depress respiration
*** FiO2<0.4 is sufficient maintain PaO2
*** No hypercarbia
*** Minimal sputum
*** Nutritional status is normal and electrolytes
*** Diaphragm and intercostals are working
*** The patient is reasonably co-operative