COPD

Patients with asthma and chronic obstructive pulmonary disease, or COPD, are a challenging patient population to mechanically ventilate. These patients are at risk for air-trapping, manifesting as increased autoPEEP, which can lead to decreased venous return and hemodynamic instability. Patients with severe COPD require sufficient time to exhale, which can be achieved with low respiratory rates, low inspiratory to expiratory ratios (I:E ratios), low inspiratory times, and high inspiratory flow rates. AutoPEEP should be monitored periodically or after any significant ventilator change.