Postoperative ventilatory management

Immediate postoperative evaluation of the patient remains a crucial role of the intensivist. Postoperative patients can be divided into the otherwise healthy, chronically ill, and acutely ill for strategizing about care. For chronically ill and acutely ill patients who require ongoing ventilation, v entilator management continues to evolve toward modes that are more interac tive with patient needs. Newer modes of ventilation are also being explored to protect the lung against damage attributable to mechanical ventilation. Weaning indexes and associated protocols have become more sophisticated an d now allow physicians greater certainty in evaluating patients' readiness for extubation. This article will discuss factors to be considered prior to extubation as well as the latest ventilatory and weaning strategies.