Ventilation challenges in obstructive airway disease patients

Sim Wen Yuan
Tan Tock Seng Hospital, Singapore

Patients with severe exacerbations of obstructive airway disease can be among the most difficult to ventilate. The initial goal in ventilating a patient with obstructive airway disease is to facilitate controlled hypoventilation and limit harmful dynamic hyperinflation/auto-PEEP. This presentation will outline how to do this and how to monitor for dynamic hyperinflation/auto-PEEP. It will also address the challenging issue of setting PEEP in these patients – the role and hence setting of PEEP can be very different in the initial acute phase when the patient is under controlled mechanical ventilation vs. in the convalescent phase when the patient is spontaneously breathing.