Critical Care Obstetrics part 15 provides expert clinical guidance throughout on how you can maximize the chances of your patient and her baby surviving trauma. In this stimulating text, internationally recognized experts guide you through the most challenging situations you as an obstetrician are likely to face, enabling you to skillfully:Recognize conditions early-on which might prove life threatening, Implement immediate life-saving treatments in emergency situations, Maximize the survival prospects of both the mother and her fetus | Ventilator Management in Critical Illness Table Oxygen delivery systems. Type F O2 capability Comments Nasal cannula Standard Reservoir type True FiO2 uncertain and highly dependent on inspiratory flow rate True FiO2 uncertain and highly dependent on inspiratory flow rate Flow rates should be limited to 5L min Severalfold less flow required than with standard cannula Transtracheal cannula FiO2 less dependent on inspiratory flow rate Usual flow rates of L min Ventimask Available at 24 28 31 35 40 and 50 Less comfortable but provides a relatively controlled FiO2. Poorly humidified gas at maximum Fi O2 High humidity mask Variable from 28 to nearly 100 Levels 60 may require additional oxygen bleed-in. Flow rates should be 2-3 times minute ventilation. Excellent humidification Reservoir mask Non-rebreathing Partial rebreathing Not specified but about 90 if well fitted Not specified but about 60-80 Reservoir fills during expiration and provides an additional source of gas during inspiration to decrease entrainment of room air Face tent Variable same as high humidity mask Mixing with room air makes actual O2 concentration inspired unpredictable T-tube Variable same as high humidity mask For spontaneous breathing through endotracheal or tracheostomy tube. Flow rates should be 2-3 times minute ventilation Table Selection guidelines for non-invasive positive-pressure ventilation use in acute respiratory failure. Respiratory failure or insufficiency without need for immediate intubation with the following acute respiratory acidosis respiratory distress use of accessory muscles or abdominal paradox Cooperative patient Hemodynamic stability No active cardiac arrhythmias or ischemia No active upper gastrointestinal bleeding No excessive secretions Intact upper airway function No acute facial trauma Proper mask fit achieved Reproduced by permission from Meyer TJ Hill NS. Non-invasive positive-pressure ventilation to treat respiratory failure. Ann Intern Med 1994
