The Use of Ventilatory Modes allowing Spontaneous Breathing during Mechanical Ventilation
The primary goal of mechanical ventilation is to restore gas exchange and to limit patients with acute respiratory failure from an elevated breathing workload. To achieve these goals a variety of different ventilatory modalities are already in clinical use. The development of microprocessor-driven mechanical ventilators has facilitated enormous progress in the implementation of different new modes of ventilatory support into standard ventilators. Most of the newer ventilatory modes are designed for partial ventilatory support reflecting that different technical approaches might be used for patient/ventilator interaction during assisted mechanical ventilation. However, the increasing use of partial support modalities is not only due to technological improvements but also to data showing that avoiding controlled mechanical ventilation by preserving some spontaneous breathing activity by the diaphragm might be beneficial for gas exchange, hemodynamics, and the clinical course of acute lung injury (ALI). In this chapter, we will review the role of preserved spontaneous breathing activity during mechanical ventilation in patients with acute respiratory failure.
KeywordsContinuous Positive Airway Pressure Acute Lung Injury Acute Respiratory Failure Pressure Support Respir Crit
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