Airway management and artificial ventilation in intensive care

Abstract

This article defines the indication for airway-securing measures and describes the actual state of knowledge about the available techniques. Various modes of ventilation and their rationale are presented. New techniques in airway management and ventilation strategy are presented, explained and evaluated. Respiratory failure is a major confounding factor of morbidity and mortality in critical care patients and contributes considerably to prolonged intensive-care unit stay. When respiratory impairment is acute, rapid assessment of essential respiratory functions such as airway patency, gas exchange, and cough function have the highest priority in patients in life-threatening conditions. Securing the airway is a basic and vital procedure that has to be applied either in an elective or an emergency situation. Various levels of difficulty in laryngoscopy, intubation and maintaining oxygenation can occur and require standardized protocols, an adequate level of expertise and appropriate equipment. In intubated patients as well as in patients without secured airway, ventilatory assistance of various degrees and invasivities may be required. In this article all clinically applied forms of ventilation, their advantages and disadvantages as well as the relevant settings are extensively presented and discussed.