Today our topic of discussion is Indications of Ventilatory Support.
Indications of Ventilatory Support
Indications for Ventilatory Support
- In upper airway obstruction like if the patient has a paralyzing disease or unconsciousness owing to severe head injury.
- In lower airway obstruction respiratory impairment is the result of blockage caused by blood or pus. Other reasons are bronchospasm and edema .
- Neuromuscular Ventilatory muscle inadequacy occurs when muscles of ventilation are diseased as in myasthenia gravis, poliomyelitis, Guillain-Barré syndrome, snake bite and inadequate reversal of anesthesia. Nerve supply to the intercostal muscles can be interrupted by spinal injury.
- Lung disease which prevents proper exchange of oxygen and carbon dioxide as in chest injuries pneumothorax. Infections of lungs, Infiltrative lung disease, chronic obstructive lung disease and adult respiratory distress syndrome.
- High-risks patients who are potential for developing respiratory failure are given ventilatory support which would help in lessening the work of breathing as in post-operative cardiac surgery, any other major surgery, shock and trauma.
- Respiratory arrest respiratory depression to the point of apnea can be produced by changes such as muscle relaxants, opiates, barbiturates, tranquilizers and anti- depressant drugs.Overdose of these drugs and any other systemic condition resulting in respiratory arrest, ventilatory support is indicated.
Equipment
Bed, locker with necessary articles, ventilator. Suction apparatus, continuous monitoring apparatus, resuscitation crash cart with defibrillator. Oxygen giving set and manual ventilation bag (Ambu bag).
Clinical parameters indicating ventilatory support are: Respiratory rate >40/minute
- Tidal volume <5 ml./kg .
- Vital capacity <15 mL/kg
- PaO, <50 mm of Hg with FiO > 0.60
- PaCO >55 >mm of Hg with PH <7.25.
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