Mechanical Ventilation Strategies for the Patient with Severe Obstructive Lung Disease

Jarrod M. Mosier, Cameron D. Hypes

Research output: Contribution to journalReview articlepeer-review

8 Scopus citations

Abstract

Patients with respiratory failure due to obstructive lung disease present a challenge to the emergency physician. These patients have physiologic abnormalities that prevent adequate gas exchange and lung mechanics which render them at increased risk of cardiopulmonary decompensation when managed with invasive mechanical ventilation. This article addresses key principles when managing these challenging patients: patient-ventilator synchrony, air trapping and auto-positive end-expiratory pressure, and airway pressures. This article provides a practical workflow for the emergency physician responsible for managing these patients.

Original languageEnglish (US)
Pages (from-to)445-458
Number of pages14
JournalEmergency medicine clinics of North America
Volume37
Issue number3
DOIs
StatePublished - Aug 2019

Keywords

  • Air trapping
  • Auto-PEEP
  • Bronchospasm
  • Dynamic hyperinflation
  • Emergency department
  • Mechanical ventilation
  • Ventilatory failure

ASJC Scopus subject areas

  • Emergency Medicine

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