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==Sections==
==Background==
===[[Intubation]]===
*Intubation and ventilation typically required for [[respiratory failure]] or airway protection/severe [[altered mental status]]
*Indications
*Absolute Contraindications
*Relative Contraindications (Mnemonics for Predicting Difficulties)
*Mnemonics
*Procedure
*Complications
*Special Situations


===[[Deterioration after intubation]]===
===Categories of [[respiratory failure|Respiratory Failure]]===
*Differential and management of deterioration after intubation
*Type 1 - [[Hypoxemia]]
*Type 2 - [[hypercapnia|Hypercarbia]]
*Type 3 - Perioperative
*Type 4 - [[Shock]]


===[[Ventilation settings]]===
==Patient Positioning<ref>Greenwood J. Good Lung UP or DOWN? Maneuvers to Improve Oxygenation in Acute Respiratory Failure. Updated 7/15/2014. https://umem.org/educational_pearls/2464/.</ref>==
*Initial ventilation settings
*HOB elevation > 30 degrees
*Lung Injury Strategy
*Reverse trendelenberg at 30 degrees in obese hypoventilaters
*Obstruction Strategy
*Lateral decubitus for severe unilateral lung disease
*Making Setting Changes
**'''G'''ood lung to '''G'''round generally
**Good lung UP in these exceptions:
***Massive [[hemoptysis]] - prevent blood into dependent, good lung
***Large [[abscess]] - pus fills up dependent lung
***Unilateral [[emphysema]] - prevent hyperinflation


===[[Ventilation modes]]===
==See Also==
*Assist Control (AC)
{{Mechanical ventilation pages}}
*Synchronous Intermittent Mandatory Ventilation (SIMV)
{{Related Difficult Airway Pages}}
*Pressure Support (PS)
*Pressure Regulated Volume Control (PRVC)
*CPAP
*Control Mode
 
===[[Ventilator high pressures]]===
*High pressure alarms
*Management
 
===[[Ventilation weaning]]===
*Weaning parameters
*Failure to wean


===[[Noninvasive ventilation]]===
== Calculators ==
*CPAP
{{Aa_Gradient_Calculator}}
*BiPAP


===[[Extubation]]===
==External Links==
*Extubating after brief periods on a ventilator (ex. intubation for agitated trauma patient)
*Vent basics resource: https://emcrit.org/wp-content/uploads/2010/05/Managing-Initial-Vent-ED.pdf


==See Also==
==References==
{{Mechanical ventilation pages}}
<references/>
*[[EBQ:ARDSnet]]
*[[Ideal_body_weight_estimation|Ideal Body Weight Estimation]]


[[Category:Critical Care]]
[[Category:Critical Care]]
[[Category:Pulm]]
[[Category:Pulmonary]]

Revisión actual - 16:32 21 mar 2026

Background

Categories of Respiratory Failure

Patient Positioning[1]

  • HOB elevation > 30 degrees
  • Reverse trendelenberg at 30 degrees in obese hypoventilaters
  • Lateral decubitus for severe unilateral lung disease
    • Good lung to Ground generally
    • Good lung UP in these exceptions:
      • Massive hemoptysis - prevent blood into dependent, good lung
      • Large abscess - pus fills up dependent lung
      • Unilateral emphysema - prevent hyperinflation

See Also

Mechanical Ventilation Pages

Airway Pages

Calculators

A-a O₂ Gradient

Alveolar-arterial (A-a) O₂ Gradient
Parameter Value
Age (years)
FiO₂ (%)
PaCO₂ (mmHg)
PaO₂ (mmHg)
A-a Gradient mmHg
Expected A-a mmHg (age-adjusted normal)
Interpretation
  • Normal A-a gradient ≈ (Age/4) + 4 on room air
  • Elevated A-a gradient suggests: V/Q mismatch, shunt, or diffusion impairment
  • Normal A-a gradient + hypoxia suggests: hypoventilation or low FiO₂
References
  • Formula: A-a = [FiO₂ × (Patm – PH2O)] – (PaCO₂/0.8) – PaO₂
  • Kanber GJ, et al. The alveolar-arterial oxygen gradient in young and elderly men during air and oxygen breathing. Am Rev Respir Dis. 1968;97(3):376-381. PMID 5637791.

External Links

References

  1. ↑ Greenwood J. Good Lung UP or DOWN? Maneuvers to Improve Oxygenation in Acute Respiratory Failure. Updated 7/15/2014. https://umem.org/educational_pearls/2464/.
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