Abstract
Patients with asthma and chronic obstructive pulmonary disease, or COPD, are a challenging patient population to ventilate in the ED. These patients are at risk for air trapping, manifesting as increased autoPEEP, which can lead to decreased venous return and hemodynamic instability. These patients 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 ventilator change with an expiratory hold maneuver.
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Suggested Reading
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Wilcox, S.R., Aydin, A., Marcolini, E.G. (2019). Specific Circumstances: Asthma and COPD. In: Mechanical Ventilation in Emergency Medicine. Springer, Cham. https://doi.org/10.1007/978-3-319-98410-0_9
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DOI: https://doi.org/10.1007/978-3-319-98410-0_9
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