Complications and Pharmacologic Interventions of Invasive Positive Pressure Ventilation During Critical Illness. (August 2018)

• Record Type: Journal Article
• Authors: Newsome, Andrea Sikora; Chastain, Daniel B.; Watkins, Paige; Hawkins, W. Anthony
• Is Part Of: Journal of pharmacy technology. Volume 34:Number 4(2018)
• Page Start: 153
• Page End: 170
• Publication Date: 2018-08
• Subjects: mechanical ventilation -- critical care -- clinical pharmacy -- respiratory failure -- adult respiratory distress syndrome; Pharmacy -- Periodicals; Pharmaceutical technology -- Periodicals; Chemotherapy -- Periodicals; 615.105
• DOI: 10.1177/8755122518766594
• Languages: English
• ISSNs: 8755-1225

Abstract

Objective: To review the fundamentals of invasive positive pressure ventilation (IPPV) and the common complications and associated pharmacotherapeutic management in order to provide opportunities for pharmacists to improve patient outcomes.Data Sources: A MEDLINE literature search (1950-December 2017) was performed using the key search terms invasive positive pressure ventilation, mechanical ventilation, pharmacist, respiratory failure, ventilator associated organ dysfunction, ventilator associated pneumonia, ventilator bundles, and ventilator liberation . Additional references were identified from a review of literature citations.Study Selection and Data Extraction : All English-language original research and review reports were evaluated.Data Synthesis: IPPV is a common supportive care measure for critically ill patients. While lifesaving, IPPV is associated with significant complications including ventilator-associated pneumonia, sinusitis, organ dysfunction, and hemodynamic alterations. Optimization of pain and sedation management provides an opportunity for pharmacists to directly affect IPPV exposure. A number of pharmacotherapeutic interventions are related directly to prophylaxis against IPPV-associated adverse events or aimed at reduction of duration of IPPV.Conclusions: Enhanced knowledge of the common complications, associated pharmacotherapy, and monitoring strategies facilitate the pharmacist's ability to provide increased pharmacotherapeutic insight in a multidisciplinary intensive care unit setting.