RT Book, Section
A1 Al-Hegelan, Mashael
A1 MacIntyre, Neil R.
A2 Hall, Jesse B.
A2 Schmidt, Gregory A.
A2 Kress, John P.
SR Print(0)
ID 1107718568
T1 Novel Modes of Mechanical Ventilation
T2 Principles of Critical Care, 4e
YR 2015
FD 2015
PB McGraw-Hill Education
PP New York, NY
SN 9780071738811
LK accessmedicine.mhmedical.com/content.aspx?aid=1107718568
RD 2024/04/20
AB Mechanical  ventilators  are  support  devices,  not  therapeutic  devices.  The  clinical  goal  is  thus  to  support  gas  exchange  without  causing  harm.A  number  of  challenges  face  clinicians  in  providing  safe  and  effective  mechanical  ventilatory  support.  Two  of  the  most  important  are  (1)  supporting  gas  exchange  without  causing  injury  from  applied  pressure  or  FiO2;  (2)  providing  comfortable  interactive  support  as  the  lung  recovers.Innovations  need  to  focus  on  addressing  clinical  challenges.  Moreover,  to  be  accepted  as  “standard  of  care,”  an  innovation  must  be  shown  to  improve  an  important  clinical  outcome.Recent  innovations  focusing  on  supporting  gas  exchange  in  a  “lung  protective”  fashion  include  airway  pressure  release  ventilation,  high  frequency  ventilation,  and  adaptive  support  ventilation.Recent  innovations  focusing  on  improving  patient-ventilator  synchrony  include  various  feedback  controls  on  variable  flow-pressure-targeted  breaths,  proportional  assist  ventilation,  and  neutrally  adjusted  ventilatory  assistance.While  all  of  these  innovations  have  conceptual  appeal  and  supporting  observational  data,  none  as  yet  have  convincing  randomized  control  trial  data  demonstrating  improved  clinical  outcomes.