Mechanical ventilation for the non-critical care trained practitioner. Part 1

Abstract

There have been a recent shortage of both critical care physicians and respiratory therapists with training in mechanical ventilation that is accentuated by the recent COVID-19 crisis. Hospitalists and primary care physicians find themselves more often dealing with and treating critically ill patients on mechanical ventilation without specific training. This two part review will try to explain and simplify some of the physiologic concepts of mechanical ventilation, strategies for managements of different diseases, monitoring, brief review of some of the common modes used for support and weaning during mechanical ventilation and to address some of the adverse effects associated with mechanical ventilation. We understand the complexity of the subject and this review would not be a substitute of seeking appropriate counselling, further training, and medical knowledge about mechanical ventilation. Further free resources are available to help clinicians who feel uncomfortable making decisions with such technology Keywords: Mechanical ventilation, Driving pressure, Compliance, Resistance, Capnometry, Dead space, ARDS, PEEP, auto-PEEP, Plateau pressure, esophageal balloon