Postgraduate medicine
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Patients with chronic obstructive lung disease (COLD) experience one or more episodes of acute respiratory failure in the late years of their illness. Initial evaluation is aimed at assessing the precipitating factor or factors as well as the severity of the acute episode and the need for intubation and mechanical ventilation. Specific treatment is directed toward the individual precipitating cause, as well as toward the general relief of hypoxemia and airflow obstruction. The prognosis for recovery from most episodes of acute respiratory failure is excellent and warrants an aggressive approach.
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Postgraduate medicine · Jan 1986
Mechanical ventilation. Physiology, equipment design, and management.
The major goals of mechanical ventilation are the prevention of significant respiratory acidosis and the correction of arterial hypoxemia. Ventilators are categorized as negative- or positive-pressure types, depending on their effect on airway pressure. Positive-pressure ventilators, which are used in the treatment of acute respiratory failure, may be subclassified as pressure-, volume-, or time-cycled. ⋯ Ventilation may be provided in a number of modes. No clear-cut advantage of intermittent mandatory ventilation over assisted mechanical ventilation has been demonstrated. By following simple guidelines, the clinician can initiate mechanical ventilation that provides an ideal ventilatory pattern.