Respiratory Failure/Mechanical Ventilation

Indications for intubation

• Is there failure of airway maintenance or protection?
  • Upper airway obstruction, airway protection
• Is there a failure of oxygenation or ventilation?
  • Uncorrectable hypoxemia (pO2 <70 mmHg on 100% O2 NRB)
  • Hypercapnea (pCO2 >55 mmHg) with acidosis [clinical judgement for pCO2 in COPD]
  • Ineffective respiration (max inspiratory force <25 cm H2O)
• Does the anticipated clinical course require intubation?
  • Fatigue (RR>35 with increasing pCO2)

Initial ventilator settings

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