Management of Mechanical Ventilation in Decompensated Heart Failure

Brooks T Kuhn; Laura A Bradley; Timothy M Dempsey; Alana C Puro; Jason Y Adams

doi:10.3390/jcdd3040033

Management of Mechanical Ventilation in Decompensated Heart Failure

J Cardiovasc Dev Dis. 2016 Dec 2;3(4):33. doi: 10.3390/jcdd3040033.

Authors

Brooks T Kuhn^{1

2}, Laura A Bradley³, Timothy M Dempsey⁴, Alana C Puro⁵, Jason Y Adams^{6

7}

Affiliations

¹ Division of Pulmonary, Critical Care and Sleep Medicine, Department of Internal Medicine, University of California at Davis, Sacramento, CA 95818, USA. btkuhn@ucdavis.edu.
² Department of Internal Medicine, School of Medicine, University of California at Davis, Sacramento, CA 95818, USA. btkuhn@ucdavis.edu.
³ Department of Internal Medicine, School of Medicine, University of California at Davis, Sacramento, CA 95818, USA. labradley@ucdavis.edu.
⁴ Department of Internal Medicine, School of Medicine, University of California at Davis, Sacramento, CA 95818, USA. tdempsey@ucdavis.edu.
⁵ Department of Internal Medicine, School of Medicine, University of California at Davis, Sacramento, CA 95818, USA. apuro@ucdavis.edu.
⁶ Division of Pulmonary, Critical Care and Sleep Medicine, Department of Internal Medicine, University of California at Davis, Sacramento, CA 95818, USA. jyadams@ucdavis.edu.
⁷ Department of Internal Medicine, School of Medicine, University of California at Davis, Sacramento, CA 95818, USA. jyadams@ucdavis.edu.

Abstract

Mechanical ventilation (MV) is a life-saving intervention for respiratory failure, including decompensated congestive heart failure. MV can reduce ventricular preload and afterload, decrease extra-vascular lung water, and decrease the work of breathing in heart failure. The advantages of positive pressure ventilation must be balanced with potential harm from MV: volutrauma, hyperoxia-induced injury, and difficulty assessing readiness for liberation. In this review, we will focus on cardiac, pulmonary, and broader effects of MV on patients with decompensated HF, focusing on practical considerations for management and supporting evidence.

Keywords: congestive heart failure; mechanical ventilation; weaning.

Publication types

Review