Control of the Work of Breathing

Control of breathing is required when tachypnea accompanies shock. Respiratory muscles are significant consumers of precious D o2 during shock and contribute to lactic acid production. Mechanical ventilation and sedation and decrease the work of breathing in shock and have been shown to improve survival. In the absence of a full shock picture, arterial blood-gas analysis can assist in the decision to perform intubation and mechanical ventilation. Sa o2 should be restored to greater than 93 percent and ventilation controlled to maintain a Pa co2 of 35 to 40 mmHg. Attempts to normalize pH above 7.3 by hyperventilation are not beneficial. Mechanical ventilation not only provides oxygenation and corrects hypercapnia, but assists, controls, and synchronizes ventilation, which ultimately decreases the work of breathing.

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