Abstract
Abstract:Invasive mechanical ventilation is a lifesaving intervention for patients with respiratory failure. The most commonly used modes of mechanical ventilation are assist-control, synchronized intermittent mandatory ventilation, and pressure support ventilation. When employed as a diagnostic tool, the ventilator provides data on the static compliance of the respiratory system and airway resistance. The clinical scenario and the data obtained from the ventilator allow the clinician to provide effective and safe invasive mechanical ventilation through manipulation of the ventilator settings. While life-sustaining in many circumstances, mechanical ventilation may also be toxic and should be withdrawn when clinically appropriate.
This content is limited to qualifying members.
If you have an existing account please login now to access this article or view purchase options.
Create a free account, then purchase this article to download or access it online for 24 hours.
Create a free account, then purchase a subscription to get complete access to all articles for a full year.
References
References1. Esteban A, Anzueto A, Alia I, et al. How is mechanical ventilation employed in the intensive care unit? An international review. Am J Respir Crit Care Med 2000;161:1450–1458.EstebanA]]AnzuetoA]]AliaI&etal;How is mechanical ventilation employed in the intensive care unit? An international review.Am J Respir Crit Care Med20001611450-14582. Gali B, Goyal DG. Positive pressure mechanical ventilation. Emerg Med Clin North Am 2003;21:453–473.GaliB]]GoyalDGPositive pressure mechanical ventilation.Emerg Med Clin North Am200321453-4733. Chiumello D, Pelosi P, Calvi E, et al. Different modes of assisted ventilation in patients with acute respiratory failure. Eur Respir J 2002;20:925–933.ChiumelloD]]PelosiP]]CalviE&etal;Different modes of assisted ventilation in patients with acute respiratory failure.Eur Respir J200220925-9334. Marini JJ, Capps JS, Culver BH. The inspiratory work of breathing during assisted mechanical ventilation. Chest 1985;87:612–618.MariniJJ]]CappsJS]]CulverBHThe inspiratory work of breathing during assisted mechanical ventilation.Chest198587612-6185. Al-Saady N, Bennett D. Decelerating inspiratory flow wave form improves lung mechanics and gas exchange in patients on intermittent positive pressure ventilation. Intensive Care Med 1985;11:68–75.Al-SaadyN]]BennettDDecelerating inspiratory flow wave form improves lung mechanics and gas exchange in patients on intermittent positive pressure ventilation.Intensive Care Med19851168-756. Tobin MJ, Lodato RF. PEEP, auto-PEEP, and waterfalls. Chest 1989;96:449–451.TobinMJ]]LodatoRFPEEP, auto-PEEP, and waterfalls.Chest198996449-4517. Sassoon CS, Zhu E, Caiozzo VJ. Assist-control mechanical ventilation attenuates ventilator-induced diaphragmatic dysfunction. Am J Respir Crit Care Med 2004;170:626–632.SassoonCS]]ZhuE]]CaiozzoVJAssist-control mechanical ventilation attenuates ventilator-induced diaphragmatic dysfunction.Am J Respir Crit Care Med2004170626-6328. Groeger JS, Levinson MR, Carlon GC. Assist control versus synchronized intermittent mandatory ventilation during acute respiratory failure. Crit Care Med 1989;17:607–612.GroegerJS]]LevinsonMR]]CarlonGCAssist control versus synchronized intermittent mandatory ventilation during acute respiratory failure.Crit Care Med198917607-6129. Christopher KL, Neff TA, Bowman JL, et al. Intermittent mandatory ventilation systems. Chest 1985;87:625–630.ChristopherKL]]NeffTA]]BowmanJL&etal;Intermittent mandatory ventilation systems.Chest198587625-63010. Sassoon CS, Del Rosario N, Fei R, et al. Influence of pressure- and flow-triggered synchronous intermittent mandatory ventilation on inspiratory muscle work. Crit Care Med 1994;22:1933–1941.SassoonCS]]Del RosarioN]]FeiR&etal;Influence of pressure- and flow-triggered synchronous intermittent mandatory ventilation on inspiratory muscle work.Crit Care Med1994221933-194111. Marini JJ, Crooke PS, Truwit JD. Determinants of pressure-preset ventilation: a mathematical model of pressure control. J Appl Physiol 1989;67:1081–1092.MariniJJ]]CrookePS]]TruwitJDDeterminants of pressure-preset ventilation: a mathematical model of pressure control.J Appl Physiol1989671081-109212. MacIntyre NR. Respiratory function during pressure support ventilation. Chest 1986;89:677–683.MacIntyreNRRespiratory function during pressure support ventilation.Chest198689677-68313. Giuliani R, Mascia L, Recchia F, et al. Patient-ventilator interaction during synchronized intermittent mandatory ventilation. Effects of flow triggering. Am J Respir Crit Care Med 1995;151:1–9.GiulianiR]]MasciaL]]RecchiaF&etal;Patient-ventilator interaction during synchronized intermittent mandatory ventilation. Effects of flow triggering.Am J Respir Crit Care Med19951511-914. Fiastro JF, Habib MP, Quan SF. Pressure support compensation for inspiratory work due to endotracheal tubes and demand continuous positive airway pressure. Chest 1988;93:499–505.FiastroJF]]HabibMP]]QuanSFPressure support compensation for inspiratory work due to endotracheal tubes and demand continuous positive airway pressure.Chest198893499-50515. Tobin MJ. Mechanical ventilation. N Engl J Med 1994;330:1056–1061.TobinMJMechanical ventilation.N Engl J Med19943301056-106116. Tobin MJ. Advances in mechanical ventilation. N Engl J Med 2001;344:1986–1996.TobinMJAdvances in mechanical ventilation.N Engl J Med20013441986-199617. Brunet F, Jeanbourquin D, Monchi M, et al. Should mechanical ventilation be optimized to blood gases, lung mechanics, or thoracic CT scan? Am J Respir Crit Care Med 1995;152:524–530.BrunetF]]JeanbourquinD]]MonchiM&etal;Should mechanical ventilation be optimized to blood gases, lung mechanics, or thoracic CT scan?Am J Respir Crit Care Med1995152524-53018. Calfee CS, Matthay MA. Recent advances in mechanical ventilation. Am J Med 2005;118:584–591.CalfeeCS]]MatthayMARecent advances in mechanical ventilation.Am J Med2005118584-59119. Ventilation with lower tidal volumes as compared with traditional tidal volumes for acute lung injury and the acute respiratory distress syndrome. The Acute Respiratory Distress Syndrome Network. N Engl J Med 2000;342:1301–1308.&NA;Ventilation with lower tidal volumes as compared with traditional tidal volumes for acute lung injury and the acute respiratory distress syndrome. The Acute Respiratory Distress Syndrome Network.N Engl J Med20003421301-130820. Corbridge TC, Hall JB. The assessment and management of adults with status asthmaticus. Am J Respir Crit Care Med 1995;151:1296–1316.CorbridgeTC]]HallJBThe assessment and management of adults with status asthmaticus.Am J Respir Crit Care Med19951511296-131621. Smith TC, Marini JJ. Impact of PEEP on lung mechanics and work of breathing in severe airflow obstruction. J Appl Physiol 1989;65:1488–1499.SmithTC]]MariniJJImpact of PEEP on lung mechanics and work of breathing in severe airflow obstruction.J Appl Physiol1989651488-149922. Tuxen DV. Permissive hypercapnic ventilation. Am J Respir Crit Care Med 1994;150:870–874.TuxenDVPermissive hypercapnic ventilation.Am J Respir Crit Care Med1994150870-87423. Tablan OC, Anderson LJ, Arden NH, et al. Guideline for prevention of nosocomial pneumonia. The Hospital Infection Control Practices Advisory Committee, Centers for Disease Control and Prevention. Am J Infect Control 1994;22:247–292.TablanOC]]AndersonLJ]]ArdenNH&etal;Guideline for prevention of nosocomial pneumonia. The Hospital Infection Control Practices Advisory Committee, Centers for Disease Control and Prevention.Am J Infect Control199422247-29224. Esteban A, Frutos F, Tobin MJ, et al. A comparison of four methods of weaning patients from mechanical ventilation. Spanish Lung Failure Collaborative Group. N Engl J Med 1995;332:345–50.EstebanA]]FrutosF]]TobinMJ&etal;A comparison of four methods of weaning patients from mechanical ventilation. Spanish Lung Failure Collaborative Group.N Engl J Med1995332345-5025. Esteban A, Alia I, Tobin MJ, et al. Effect of spontaneous breathing trial duration on outcome of attempts to discontinue mechanical ventilation. Spanish Lung Failure Collaborative Group. Am J Respir Crit Care Med 1999;159:51–82.EstebanA]]AliaI]]TobinMJ&etal;Effect of spontaneous breathing trial duration on outcome of attempts to discontinue mechanical ventilation. Spanish Lung Failure Collaborative Group.Am J Respir Crit Care Med199915951-82
