Basic Principles of Mechanical Ventilation

  • Waldemar A. CarloEmail author
  • Namasivayam Ambalavanan
  • Robert L. Chatburn
  1. I.

    The ventilatory needs of a patient depend largely on the mechanical properties of the respiratory system and the type of abnormality in gas exchange.

  2. II.
    Pulmonary mechanics
    1. A.

      The mechanical properties of the lungs is a determinant of the interaction between the ventilator and the infant.

    2. B.

      A pressure gradient between the airway opening and alveoli drives the flow of gas.

    3. C.

      The pressure gradient necessary for adequate ventilation is largely determined by the compliance and resistance (see below).

  3. III.
    1. A.

      Compliance describes the elasticity or distensibility of the lungs or respiratory system (lungs plus the chest wall).

    2. B.
      It is calculated as follows:
      $$ \text{Compliance = }\frac{\Delta \text{Volume}}{\Delta \text{Pressure}}.$$


Tidal Volume Airway Pressure Peak Inspiratory Pressure Mixed Venous Blood Expiratory Time 
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Suggested Reading

  1. Carlo WA, Chatburn RL. Assisted ventilation of the newborn. In: Carlo WA, Chatburn RL, editors. Neonatal respiratory care. 2nd ed. Chicago: Year Book Medical Publishers; 1988. p. 320–46.Google Scholar
  2. Carlo WA, Greenough A, Chatburn RL. Advances in conventional mechanical ventilation. In: Boynton BR, Carlo WA, Jobe AH, editors. New therapies for neonatal respiratory failure: a physiologic approach. Cambridge, England: Cambridge University Press; 1994. p. 131–51.Google Scholar
  3. Donn SM, editor. Neonatal and pediatric pulmonary graphics: principles and clinical applications. Armonk, NY: Futura Publishing Co.; 1997.Google Scholar
  4. Greenough A, Milner AD, editors. Neonatal respiratory disorders. London: Arnold Publishers; 2003.Google Scholar
  5. Krauss AN. Ventilation-perfusion relationship in neonates. In: Thibeault DW, Gregory GA, editors. Neonatal pulmonary care. 2nd ed. Norwalk, CT: Appleton; 1986. p. 127.Google Scholar
  6. Mariani GL, Carlo WA. Ventilatory management in neonates. Controversies in Neonatal Pulmonary Care. 1998;25:33–48.Google Scholar
  7. Spitzer AR, Fox WW. Positive-pressure ventilation: pressure-limited and time-cycled ventilators. In: Goldsmith JP, Karotkin EH, editors. Assisted ventilation of the neonate. 4th ed. Philadelphia, PA: WB Saunders Co; 2004. p. 167–86.Google Scholar
  8. West JB. Gas exchange. In: West JB, editor. Pulmonary pathophysiology—the essentials. 6th ed. Baltimore, MD: Williams & Wilkins; 2003.Google Scholar

Copyright information

© Springer Science+Business Media, LLC 2012

Authors and Affiliations

  • Waldemar A. Carlo
    • 1
    Email author
  • Namasivayam Ambalavanan
    • 1
  • Robert L. Chatburn
    • 2
  1. 1.Division of Neonatology, Department of PediatricsUniversity of Alabama at BirminghamBirminghamUSA
  2. 2.Cleveland Clinic, Respiratory InstituteClevelandUSA

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