Multiprofessional Critical Care Review: Adult 2024 (MCCRCA24ON)-Board Questions: Respiratory Disease, Mechanical Ventilation, and Noninvasive Support

Board Questions: Respiratory Disease, Mechanical Ventilation, and Noninvasive Support

Video Transcription

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.

Asset Caption

Robert A. Balk, MD, MCCM; Khalilah Gates, MD

Meta Tag

Concept Acute Hypoxemic Respiratory Failure

Concept Acute Respiratory Distress Syndrome

Concept Massive Pulmonary Embolism

Concept Peak Airway Pressure

Concept Plateau Pressure

Keywords

non-invasive ventilation

extubation

intubated

COPD exacerbation

extubation failure

CABG surgery

esophagectomy

Acute Hypoxemic Respiratory Failure

Acute Respiratory Distress Syndrome

Massive Pulmonary Embolism

Peak Airway Pressure

Plateau Pressure

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