Mechanical Ventilation: A Tutorial for Pharmacists

Cawley, Michael J.

doi:10.1592/phco.27.2.250

Cited by 11 publications

(12 citation statements)

References 74 publications

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“…IMV and SIMV also deliver a preset time-cycled V T breath but allow the patient the ability for spontaneous breathing between each preset time-cycled breath. 6 Adjunctive modes such as PSV and CPAP do not provide a time-cycled mechanical breath but provide pressure augmentation to assist in the weaning process before liberation from mechanical ventilation. Positive end-expiratory pressure (PEEP) is also an adjunctive mode that primarily maintains a set pressure in the lungs during the exhalation phase of a mechanical ventilated breath.…”

Section: Review Of Conventional Modes Of Mechanical Ventilationmentioning

confidence: 99%

“…PEEP is traditionally added to a time-cycled ventilator mode and initiated in patients experiencing hypoxia on a fraction of inspired oxygen (F io 2 ) greater than 50%. 6…”

Section: Review Of Conventional Modes Of Mechanical Ventilationmentioning

confidence: 99%

“…There exists a paucity of published literature focused on assisting pharmacists in understanding mechanical ventilation. [4][5][6][7] With a better understanding of mechanical ventilation including conventional and advanced ventilator modes, oxygen and ventilatory goals, and weaning strategies, pharmacists can better assist the medical team in creating ventilator weaning protocols to optimize patient care outcomes.…”

Section: Introductionmentioning

confidence: 99%

“…For practitioners with a limited understanding of mechanical ventilation, the author strongly encourages the reader to review a more generalized and introductory overview of mechanical ventilation focused for the pharmacists. 6,7 In reviewing this manuscript, the author recommends to review the pressure waveform figures during reading of each mode of ventilation. This may assist in clarifying the respiratory cycle process including changes during the inspiratory and expiratory ventilator phase.…”

Section: Introductionmentioning

confidence: 99%

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Advanced Modes of Mechanical Ventilation: Introduction for the Critical Care Pharmacist

Cawley

2017

Journal of Pharmacy Practice

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Mechanical ventilation continues to be an evolving modality in the critical care environment. Technological advances in microprocessor-controlled ventilation integrated with the complexity of new ventilator modes has provided the multidisciplinary team opportunities to further improve the care of the critically ill ventilator patients. As members of the critical care multidisciplinary team, pharmacists require a basic understanding of both conventional and advanced modes of mechanical ventilation in order to assist in optimizing medication use and ultimately patient health-care outcomes. Pharmacists have a key responsibility to practice vigilance to maintain safe drug therapy use by preventing drug-drug or drug-disease interactions and optimal dose selection based upon pharmacokinetics and pharmacodynamics principles. Pharmacists also assist in the development of drug utilization guidelines and pharmacological ventilator-weaning protocols based upon evidence-based practice. The result of these responsibilities must include the continued longitudinal assessment and reporting of quality measures to assess ventilator weaning, time to liberation of mechanical ventilation, and length of care in intensive care unit. The purpose of this article is to provide the clinical pharmacist a guide to a basic understanding of advanced modes of mechanical ventilation in adults and to apply the knowledge gained to assist in the care of the critical care patients.

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Section: Review Of Conventional Modes Of Mechanical Ventilationmentioning

confidence: 99%

“…PEEP is traditionally added to a time-cycled ventilator mode and initiated in patients experiencing hypoxia on a fraction of inspired oxygen (F io 2 ) greater than 50%. 6…”

Section: Review Of Conventional Modes Of Mechanical Ventilationmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Advanced Modes of Mechanical Ventilation: Introduction for the Critical Care Pharmacist

Cawley

2017

Journal of Pharmacy Practice

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“…Limited data have been published in the pharmacy literature discussing mechanical ventilation. 1 –3 The inclusion of pharmacists during the discussion of the ventilator plan of the patient provides expert knowledge of pharmacological agent delivery including appropriate drug selection, accurate dose and dose titration, and monitoring of agents that may impede ventilator weaning outcomes.…”

Section: Introductionmentioning

confidence: 99%

Mechanical Ventilation

Cawley

2010

Journal of Pharmacy Practice

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Mechanical ventilation is a common therapeutic modality required for the management of patients unable to maintain adequate intrinsic ventilation and oxygenation. Mechanical ventilators can be found within various hospital and nonhospital environments (ie, nursing homes, skilled nursing facilities, and patient's home residence), but these devices generally require the skill of a multidisciplinary health care team to optimize therapeutic outcomes. Unfortunately, pharmacists have been excluded in the discussion of mechanical ventilation since this therapeutic modality may be perceived as irrelevant to drug utilization and the usual scope of practice of a hospital pharmacist. However, the pharmacist provides a crucial role as a member of the multidisciplinary team in the management of the mechanically ventilated patient by verifying accuracy of prescribed medications, providing recommendations of alternative drug selections, monitoring for drug and disease interactions, assisting in the development of institutional weaning protocols, and providing quality assessment of drug utilization. Pharmacists may be intimidated by the introduction of advanced ventilator microprocessor technology, but understanding and integrating ventilator management with the pharmacotherapeutic needs of the patient will ultimately help the pharmacist be a better qualified and respected practitioner. The goal of this article is to assist the pharmacy practitioner with a better understanding of mechanical ventilation and to apply this information to improve delivery of pharmaceutical care.

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Part I: Anesthesia and ventilator management in critical care patients

Patel¹,

Muir²

2021

J Am Coll Clin Pharm

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Mechanical Ventilation: A Tutorial for Pharmacists

Cited by 11 publications

References 74 publications

Advanced Modes of Mechanical Ventilation: Introduction for the Critical Care Pharmacist

Advanced Modes of Mechanical Ventilation: Introduction for the Critical Care Pharmacist

Mechanical Ventilation

Part I: Anesthesia and ventilator management in critical care patients

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