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Chapter 7 - Prolonged Ventilator Dependence for the Pulmonary Patient

Published online by Cambridge University Press:  27 May 2021

By
Matthew Wilson  and
Philip Choi
Edited by
Matthew N. Jaffa  and
David Y. Hwang
Matthew N. Jaffa
Affiliation:
Hartford Hospital, Connecticut
David Y. Hwang
Affiliation:
Yale University, Connecticut
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Summary

Mr. Smith is a 68-year-old man with chronic obstructive lung disease on supplemental oxygen who presented to the emergency department with influenza A and a Staphylococcus aureus superinfection. The patient was admitted to the intensive care unit (ICU) and underwent endotracheal intubation with mechanical ventilation for acute respiratory distress syndrome. After 10 days of appropriate antibiotics, Mr. Smith’s respiratory status has significantly improved. He is now requiring minimal support from the ventilator with an FiO2 of 40% and 5 cmH20 of positive end-expiratory pressure. Unfortunately, he has repeatedly failed daily spontaneous breathing trials. Due to his prolonged ICU course, he is physically deconditioned and now dependent on mechanical ventilation.

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Chapter
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Shared Decision Making in Adult Critical Care , pp. 51 - 58
Publisher: Cambridge University Press
Print publication year: 2021

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