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Monaldi Arch Chest Dis · Jun 1998
ReviewInvasive mechanical ventilation in exacerbations of chronic obstructive pulmonary disease.
- S K Pingleton.
- Division of Pulmonary and Critical Care Medicine, University of Kansas Medical Center, Kansas City 66160, USA.
- Monaldi Arch Chest Dis. 1998 Jun 1;53(3):337-42.
AbstractExacerbations of chronic obstructive pulmonary disease are appropriately treated when severe airflow obstruction does not respond to intensive therapy, including, at times, noninvasive mechanical ventilation. Ventilatory strategies include avoidance of the ventilatory complications of dynamic pulmonary hyperinflation with its resultant intrinsic positive end-expiratory pressure, thereby decreasing the risk of hypotension and barotrauma. Initial ventilator settings should include an expiratory flow rate between 8-10 L.min-1, a tidal volume of 8-10 mL.kg-1 and a respiratory rate of 11-14 breaths.min-1 as well as an inspiratory flow rate of 100 L.min-1. Further adjustments are made on the basis of gas exchange and pulmonary mechanics. Medical therapies include beta-agonists and corticosteroids.
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