Respiratory and Mechanical Ventilation Management: Avoidance of Complications

Invasive mechanical ventilation (IMV) is a live-saving strategy often implemented in critically ill patients to overcome respiratory failure from either acute, exacerbated or planned (e.g. surgery) clinical situations. However, the use of IMV is not without risk and several respiratory adverse effects may result from its use, increasing morbidity and healthcare costs in these patients. Indeed, mucus retention is highly prevalent in the critically ill, independent of a pre-existent respiratory disease, with associated risk for atelectasis or respiratory infections. Moreover, respiratory muscle weakness is also recognised as a common adverse effect derived from IMV, which may result in a prolonged need for ventilation or longer intensive care unit lengths of stay. The knowledge of pathophysiological consequences derived from IMV and adequate respiratory management of critically ill patients is mandatory to ensure the quality of daily care in these patients, whilst also maximising the potential for a successful ICU discharge. Thus, the purpose of this chapter is to describe the basics of pulmonary complications resulting from intubation and the use of mechanical ventilation in critically ill adults, presenting the most commonly implemented strategies for its management.