Mechanical ventilation - Complications/Monitoring

COMPLICATIONS

Due to the nature of positive pressure ventilation (PPV) there are two important complications:

  • Barotrauma - e.g. pneumothorax
  • Hypotension (because the lungs can compress the blood vessels entering and leaving the heart)

Prolonged increases in  FiO2 can lead to:

  • ARDS

These complications are minimised by using the lowest mean pressures (max 35mmHg) and avoiding high peak pressure (max 50mmHg)  and the least FiO2 required to maintain adequate gas exchange.

ALARMS

  • Either inbuilt or attached to a ventilator
  • May include alarms to sense inadequate/excessive
  • Tidal volume
  • Airway pressure
  • ET CO2 
  • FiO2 

see Causes of Volume/Pressure Alarms

MONITORING

In addition to the alarms above, the following monitoring is required:

  • Continuous SpO2/BP/ECG monitoring
  • ABG (take 15min after initiation)
 
Disclaimer: Note: The information described here relates solely to operational matters in the Emergency Department.  Every effort has been made to verify the accuracy of the content. However, neither the author or the hospital will take responsibility for errors resulting from its use.  Please refer to your own departmental guidelines and verify all clinical decisions with a reliable source.  

Date Last Reviewed: 05/08/2004