Initiating Mechanical Ventilation

Indications for Initiating Mechanical Ventilation

Clinical assessment outweighs any objective measurement such as an arterial blood gas or chest x-ray.


Consider initiating mechanical ventilation in the absence of:

    • An impaired conscious state

    • A threatened airway

    • Fatigue or imminent exhaustion

    • An inability to effectively cough or clear secretions

    • Progressive hypoxaemia evidenced by pulse Oximetry

In the appropriate clinical setting, and where time allows the following objective measurements may assist in making the decision to initiate mechanical ventilation.

    • A respiratory rate of greater than 30 breaths per minute or a progressive increase in respiratory rate.

    • Abnormal oxygenation as evidenced by a PaO2  of less than 75 mmHg on greater than 40% inspired oxygen

    • A depressed minute ventilation as evidenced by a rising PaCO2

    • Level of consciousness


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Page last reviewed: 13 May 2014