316 Ch 315. Mechanical Ventilation

Mechanical ventilation 分 invasive (intubation) vs non-invasive (NIV)；indications：respiratory failure (acute hypoxemic / hypercapnic)、airway protection、severe shock、neurologic emergency；modes：volume-controlled (VCV)、pressure-controlled (PCV)、pressure support (PSV)、SIMV、APRV (airway pressure release ventilation)；lung-protective ventilation core (ARDSnet)：Vt 6 mL/kg PBW + plateau < 30 + PEEP titrated + driving pressure < 15；weaning strategies：spontaneous breathing trial (SBT) daily + sedation interruption (SAT)；ventilator-associated complications：VAP (ventilator-associated pneumonia)、VILI、auto-PEEP、ventilator dyssynchrony、tracheal stenosis；high flow nasal cannula (HFNC) + NIV 為 alternative；weaning failure：assess physiology + correct underlying；post-extubation respiratory failure：HFNC + NIV preferred over reintubation；ECMO (VV/VA) for refractory；diaphragm pacing for chronic ventilation；chronic mechanical ventilation：weaning units、home ventilation。