Intubation & Ventilation  Why?

Intubation of the airway is performed to:

1. Protect the upper airway from macroscopic aspiration (the carrots and peas).

2. To maintain a patent track between a breathing system and the airway.

3. Facilitate mechanical ventilation and airway toilet.

Intubation is not essential for mechanical ventilation (non invasive techniques are available), but the presence of a clear airway with a good seal in the trachea allows more precise control of respiratory gases.

Mechanical ventilation is commenced for one of two reasons:

1. Failure to ventilate.

2. Failure to oxygenate.

Quite simply, patients are either unable to move enough air into their lungs to ensure an adequate minute ventilation (manifested, in most cases, by a PaCO2 of >50 mmHg), or else are unable to move oxygen into the bloodstream (manifested by a PaO2 of <50 mmHg). Frequently, respiratory failure is a combination of both of these problems.

Copyright Patrick Neligan 2001-2002

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