Prolonged Mechanical Ventilation

Posted by e-Medical PPT
Ventilator Dependence
Systemic
Chronic comorbid conditions
Chronic Hypercapnia
Organ Failure (Renal failure especially can dramatically increase the mortality rate)

Mechanics
Increased Work of Breathing
Decreased Respiratory Muscle Capacity
Intrinsic PEEP
Airway Patency (eg. tracheal stenosis)

Iatrogenic
Unrecognized withdrawal potential
Inappropriate vent settings
MEDS (Suppress drive and muscle weakness)
Long-term hospital stay   
Infection (VAP, Sepsis/SIRS—decrease O2 uptake)
Recurrent Aspiration
DVT

Psychiatry
Sedation
Depression
Anxiety

Complications of Prolonged Mechanical Ventilation
  • Infection
  • Bacterial Pneumonia
  • Line sepsis
  • C. Diff
  • Volume Overload
  • Laryngeal Edema
  • Pneumothorax
  • Tracheal Bleeding
  • Renal Failure
  • Ileus
  • GI Bleeding
  • DVT
  • Additional Complications if Tracheostomy is necessary


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