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Multiprofessional Critical Care Review: Adult (202 ...
Board Questions: Respiratory Disease, Mechanical V ...
Board Questions: Respiratory Disease, Mechanical Ventilation, and Noninvasive Support
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Video Summary
Non-invasive ventilation after extubation is most appropriate in a patient who was intubated three days ago for exacerbation of chronic obstructive pulmonary disease (COPD). This is the classic scenario where non-invasive ventilation can be effective. In the other scenarios, it is either not indicated or contraindicated. For example, in a patient who had CABG surgery, non-invasive ventilation is not necessary as there is no risk of extubation failure. In a patient who had an esophagectomy and required re-intubation, non-invasive ventilation is contraindicated. In a patient with community-acquired pneumonia who has already been intubated and now has worsening respiratory failure, re-intubation is necessary rather than non-invasive ventilation.
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Robert A. Balk, MD, MCCM; Khalilah Gates, MD
Keywords
non-invasive ventilation
extubation
intubated
exacerbation
chronic obstructive pulmonary disease
COPD
extubation failure
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