Invasive Ventilation in Acute Respiratory Failure
| Mode of ventilation | Indications | Contraindications | Disadvantages and complications |
|---|---|---|---|
| Endotracheal intubation and mechanical ventilation | Upper airway obstruction | Patient has expressed wish not to be ventilated | Need for sedation and paralysis |
| Impending respiratory arrest | Chronic respiratory disease with severely impaired functional capacity and/or severe comorbidity | Pharyngeal, laryngeal and tracheal injury | |
| Airway at risk because of reduced conscious level (GCS <8) | Irreversible extensive neurological damage | Ventilator-associated pneumonia | |
| Oxygenation failure: PaO2<7.5–8kPa, despite supplemental oxygen/NIV | Ventilator-induced lung injury (e.g. barotrauma) | ||
| Ventilatory failure: respiratory acidosis with pH <7.25 | Weaning may pose ethical difficulties |