Management of four arterial blood gas problems in adult mechanical ventilation: decision-making algorithms and rationale for their use

Use of these algorithms does not eliminate the need to think. One must always evaluate each patient to determine if the algorithms are applicable. The algorithms provide a learning framework for any practitioner who is responsible for managing patients receiving mechanical ventilation. The effectiveness of any reference tool depends, to an extent, on the context in which it is applied. The use of these algorithms without an adequate understanding of the principles of gas exchange, acid-base balance, and the function of mechanical ventilators will probably not benefit the patient or the practitioner. The portable nature of these algorithms allows them to be used in the clinical setting. The ultimate goal, of course, is to replace the algorithms with the ability to make and justify mechanical ventilation decisions. Experience with these algorithms will also assist users in applying this approach with unfamiliar problems to find viable solutions.