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MECHANICAL VENTILATION
Mechanical ventilation or assisted ventilation is the medical term for using a ventilator machine to fully or partially provide artificial ventilation.
Mechanical ventilation helps move air into and out of the lungs, with the main goal of helping the delivery of oxygen and removal of carbon dioxide. Mechanical ventilation is used for many reasons, including to protect the airway due to mechanical or neurologic cause, to ensure adequate oxygenation, or to remove excess carbon dioxide from the lungs. Various healthcare providers are involved with the use of mechanical ventilation and people who require ventilators are typically monitored in an intensive care unit. Mechanical ventilation is termed invasive if it involves an instrument to create an airway that is placed inside the trachea. This is done through an endotracheal tube or nasotracheal tube.

Mechanical ventilation is a life-sustaining intervention that provides respiratory support to patients who are unable to breathe adequately on their own. This can be due to various conditions, including acute respiratory distress syndrome (ARDS), chronic obstructive pulmonary disease (COPD) exacerbations, pneumonia, and following major surgeries. In the UK, healthcare providers utilize both invasive (endotracheal intubation) and non-invasive ventilation techniques (NIV) to enhance oxygenation and carbon dioxide removal, tailoring the approach to each patient's unique needs.

The landscape of mechanical ventilation has been revolutionized in the UK through the development of sophisticated ventilators that offer a range of modes and settings, allowing clinicians to customize treatment strategies effectively. Modern ventilators incorporate advanced monitoring capabilities that provide real-time feedback on a patient’s respiratory status, enabling prompt adjustments to ensure optimal lung protection while minimizing potential complications.

In the UK, guidelines from organizations such as the National Institute for Health and Care Excellence (NICE) and the British Thoracic Society (BTS) have been established to support clinicians in delivering safe and effective mechanical ventilation. These guidelines emphasize the importance of evidence-based practices, including lung-protective ventilation strategies, which aim to reduce ventilator-induced lung injury (VILI) and improve patient outcomes.

Proper training and education for healthcare professionals are essential for the effective use of mechanical ventilation. In the UK, medical education programs and specialized training courses ensure that doctors, nurses, and respiratory therapists are well-equipped to manage ventilated patients. Simulation-based education has become increasingly popular, allowing healthcare providers to practice their skills in a controlled environment and develop the confidence needed for critical care situations.

Despite its benefits, the application of mechanical ventilation presents several challenges, including ventilator-associated pneumonia (VAP), patient-ventilator dysynchrony, and the need for prolonged sedation. The COVID-19 pandemic highlighted both the importance and strain on mechanical ventilation resources within the NHS, leading to a reevaluation of protocols and approaches to care.