Clinical Application of Mechanical Ventilation

Mechanical ventilation is the medical term for artificial ventilation where mechanical means is used to assist or replace spontaneous breathing. This may involve a machine called a ventilator or the breathing may be assisted by an anesthesiologist, certified registered nurse anesthetist, physician, physician assistant, respiratory therapist, paramedic, EMT, or other suitable person compressing a bag or set of bellows. Mechanical ventilation is termed "invasive" if it involves any instrument penetrating the trachea through the mouth, such as an endotracheal tube or the skin, such as a tracheostomy tube. There are two main types: positive pressure ventilation, where air is pushed into the trachea, and negative pressure ventilation, where air is, in essence, sucked into the lungs. There are many modes of mechanical ventilation, and their nomenclature has been revised over the decades as the technology has continually developed.

Mechanical ventilation is indicated when the patient's spontaneous ventilation is inadequate to maintain life. It is also indicated as prophylaxis for imminent collapse of other physiologic functions, or ineffective gas exchange in the lungs. Because mechanical ventilation serves only to provide assistance for breathing and does not cure a disease, the patient's underlying condition should be correctable and should resolve over time. In addition, other factors must be taken into consideration because mechanical ventilation is not without its complications. In general, mechanical ventilation is instituted to correct blood gases and reduce the work of breathing.


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