UMEM Educational Pearls

Mechanical Ventilation in Shock

  • Emergency physicians and intensivists routinely resuscitate patients in shock.
  • For patients who manifest signs of persistent shock (i.e., rising lactate), consider intubation and mechanical ventilation, even in the absence of acute respiratory failure.
  • The respiratory muscles are avid consumers of oxygen.  In fact, up to 50% of available O2 can be used by the respiratory muscles to perform the work of breathing.
  • Initiation of mechanical ventilation can reduce oxygen consumption and allow oxygen to be shunted to other vital organs.

References

Gidwani H, Gomez H. The crashing patient: hemodynamic collapse. Curr Opin Crit Care 2017; 23:533-540.