Ventilatory Management of Chronic Obstructive Pulmonary Disease (COPD)
Presented by John Davies
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Ventilatory management of the patient with chronic obstructive pulmonary disease (COPD) can be daunting. Small airway obstruction can change the way a ventilator needs to be managed, along with the added complexity of the involvement of dynamic hyperinflation and intrinsic positive end-expiratory pressure (PEEP). This course will provide respiratory therapists working in acute settings with the tools to identify ventilatory management needs specifically for small airway obstruction and how to minimize hyperinflation and intrinsic PEEP through ventilatory management strategies.
Meet your instructor
John Davies
John Davies is a clinical research coordinator in the field of adult critical care at Duke University Medical Center in Durham, North Carolina. He has worked at Duke for 30 years. John is one of the co-chairs of the Mechanical Ventilation Simulation Committee for the American College of Chest Physicians (ACCP) along with Dr.…
Chapters & learning objectives
1. Recognizing an Acute Exacerbation of Chronic Obstructive Pulmonary Disease (AECOPD) and Intital Management
Recognizing that a patient is experiencing an AECOPD is important in determining how to care for the patient. Noninvasive ventilation is the accepted first line of therapy after inhaled medications. This chapter will focus on the recognition and management of AECOPD.
2. How to Identify Intrinsic PEEP (PEEPi) and Its Effects on Mechanical Ventilation
PEEPi results from gas being trapped in the lungs at the end of exhalation. This elevated pressure makes it difficult for the patient to trigger the ensuing breath because the patient then has to overcome the PEEPi and the sensitivity limit of the ventilator. This chapter will discuss how to identify PEEPi and its effects on mechanical ventilation.
3. Ventilatory Strategies for an AECOPD
Optimal ventilation for a patient with an AECOPD includes strategies aimed at maximizing time spent at exhalation. This chapter will focus on these strategies—specifically, reducing the inspiratory time and reducing the respiratory rate.
4. Adjunct Supportive Strategies
This chapter will discuss other supportive strategies that have been used in the treatment of AECOPD, such as helium/oxygen mixtures (Heliox), ECMO, and ECCOR2.
