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Mechanical Ventilation in Acute Respiratory Failure: What We Have Learnt and What We Still Need to Learn

  • Conference paper
Mechanical Ventilation and Weaning

Part of the book series: Update in Intensive Care Medicine ((UICMSOFT,volume 36))

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Abstract

Many advances have been seen over the past few years regarding supportive treatment (i.e., mechanical ventilation) of patients suffering acute respiratory failure (ARF) and needing clinical management in an ICU. This progress is the result of physiological studies specifically designed to answer relevant clinical questions or to more precisely understand physiopathological mechanisms of diseases. Such studies have usually been performed first with animals, on the bench, or with small series of selected patients under strict control. The data have then been transferred to the clinical arena and used to test a specific hypothesis in still small, open or controlled clinical trials. Finally, multicenter randomized clinical trials with large numbers of patients have been designed to ascertain the impact of certain ventilatory strategies on outcome variables. Very interestingly, some of the most important clinical trials in the field of mechanical ventilation published in recent years, for instance the impact of noninvasive positive-pressure ventilation (NPPV) in acute decompensation of chronic respiratory failure, the clinical relevance of different weaning strategies, and the impact of ventilating the lungs of acute respiratory distress syndrome (ARDS) patients with low tidal volumes, are nice examples of this commonly used, well thought-out approach. Even more important, such studies, based on robust experimental, physiological, and clinical data, have provided major improvements in patients’ outcomes. In this chapter, I will comment on these seminal studies.

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Authors
  1. J. Mancebo
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Editors and Affiliations

  1. Servei de Medicina Intensiva, Hospital de la Sante Creu i Sant Pau, Av. S.A. Maria Claret 167, 08025, Barcelona, Spain

    Jordi Mancebo MD (Associate Professor of Medicine) & Alvar Net MD (Professor of Medicine) (Associate Professor of Medicine) &  (Professor of Medicine)

  2. Service Réanimation Médicale, Hôpital Henri Mondor, 51, Av. Du Mal de Lattre de Tassigny, F-94010, Créteil cedex, France

    Laurent Brochard MD (Professor of Medicine) (Professor of Medicine)

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Mancebo, J. (2003). Mechanical Ventilation in Acute Respiratory Failure: What We Have Learnt and What We Still Need to Learn. In: Mancebo, J., Net, A., Brochard, L. (eds) Mechanical Ventilation and Weaning. Update in Intensive Care Medicine, vol 36. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-56112-2_1

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  • DOI: https://doi.org/10.1007/978-3-642-56112-2_1

  • Publisher Name: Springer, Berlin, Heidelberg

  • Print ISBN: 978-3-540-44181-6

  • Online ISBN: 978-3-642-56112-2

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