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Barotrauma is a recognised complication of mechanical ventilation that can occur in any patient receiving mechanical ventilation, but is most commonly associated with acute respiratory distress syndrome. It used to be the most common complication of mechanical ventilation but can usually be avoided by limiting tidal volume and plateau pressure ...
VALI is most common in people receiving mechanical ventilation for acute lung injury or acute respiratory distress syndrome (ALI/ARDS). [1] 24 percent of people mechanically ventilated will develop VALI for reasons other than ALI or ARDS. [1] The incidence is probably higher among people who already have ALI/ARDS, but estimates vary widely. [1]
Mechanical ventilation is often a life-saving intervention, but carries potential complications. A common complication of positive pressure ventilation stemming directly from the ventilator settings include volutrauma and barotrauma. [11] [12] Others include pneumothorax, subcutaneous emphysema, pneumomediastinum, and pneumoperitoneum.
Since mechanical ventilation can worsen a pneumothorax, it can force air into the tissues; when subcutaneous emphysema occurs in a ventilated patient, it is an indication that the ventilation may have caused a pneumothorax. [2] It is not unusual for subcutaneous emphysema to result from positive pressure ventilation. [25]
Applied PEEP is usually one of the first ventilator settings chosen when mechanical ventilation is initiated. It is set directly on the ventilator. A small amount of applied PEEP (4 to 5 cmH 2 O) is used in most mechanically ventilated patients to mitigate end-expiratory alveolar collapse. [6]
The primary treatment involves mechanical ventilation together with treatments directed at the underlying cause. [1] Ventilation strategies include using low volumes and low pressures. [1] If oxygenation remains insufficient, lung recruitment maneuvers and neuromuscular blockers may be used. [1]
Larger contusions have been correlated with a need for ventilation for longer periods of time. [15] Pulmonary contusion or its complications such as acute respiratory distress syndrome may cause lungs to lose compliance (stiffen), so higher pressures may be needed to give normal amounts of air [4] and oxygenate the blood adequately. [33]
The administration of positive pressure ventilation, either mechanical ventilation or non-invasive ventilation, can result in barotrauma (pressure-related injury) leading to a pneumothorax. [ 13 ] Divers who breathe from an underwater apparatus are supplied with breathing gas at ambient pressure , which results in their lungs containing gas at ...