Mechanical ventilation complications associated with

Mechanical ventilation is associated with several complications including respiratory muscle weakness, ventilator-induced lung injury, trauma to the upper airway, and ventilator-associated pneumonia (14,15). Therefore, minimizing the duration of invasive ventilatory... 

Noninvasive positive-pressure ventilation (NPPV) provides ventilatory support with oxygen and pressurized airflow using a face or nasal mask with a tight seal but without endotracheal intubation. In patients with acute respiratory failure due to COPD exacerbations, NPPV was associated with lower mortality, lower intubation rates, shorter hospital stays, and greater improvements in serum pH in 1 hour compared with usual care. Use of NPPV reduces the complications that often arise with invasive mechanical ventilation. NPPV is not appropriate for patients with altered mental status, severe acidosis, respiratory arrest, or cardiovascular instability. 

There were, however, some convincing examples of major improvements within the run chart data collected locally some of the data capture was clearly both sustained and controlled (Box 19.4). For instance, patients received correctly timed antibiotics before surgery and the introduction of a care bundle in one site significantly reduced the incidence of ventilator associated pneumonia. In patients on mechanical ventilation, the cumulative risk of pneumonia increases with the duration of ventilation. This infection has serious potential complications and a high mortality rate, so improvement in the reliability of the care delivered has important implications. 

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