The American Journal of Medicine
Volume 118, Issue 6 , Pages 584-591, June 2005

Recent advances in mechanical ventilation

  • Carolyn S. Calfee, MD

      Affiliations

    • Cardiovascular Research Institute, San Francisco, California
    • Department of Medicine, University of California at San Francisco, San Francisco, California.
    • Corresponding Author InformationRequests for reprints should be addressed to Carolyn S. Calfee, MD, University of California, San Francisco, Pulmonary Division, 505 Parnassus Avenue, San Francisco, California 94143-0111.
  • ,
  • Michael A. Matthay, MD

      Affiliations

    • Cardiovascular Research Institute, San Francisco, California
    • Department of Medicine, University of California at San Francisco, San Francisco, California.
    • Department of Anesthesia, University of California at San Francisco, San Francisco, California.

Received 29 March 2004; accepted 28 October 2004.

Abstract 

Important advances have been made over the past decade towards understanding the optimal approach to ventilating patients with acute respiratory failure. Evidence now supports the use of noninvasive positive pressure ventilation in selected patients with hypercapnic respiratory failure and chronic obstructive pulmonary disease, cardiogenic pulmonary edema, and for facilitating the discontinuation of ventilatory support in patients with chronic pulmonary disease. The concept of a lung protective ventilatory strategy has revolutionized the management of the acute respiratory distress syndrome. The process of liberation from mechanical ventilation is becoming more standardized, with evidence supporting daily trials of spontaneous breathing in all suitable mechanically ventilated patients. This article critically reviews the most important recent advances in mechanical ventilation and suggests future directions for further research in the field.

Keywords:  Mechanical ventilation , Noninvasive ventilation , Acute respiratory distress syndrome , Weaning

 

 Supported in part by a grant from the National Heart, Lung, and Blood Institute (NHLBI RO1-HL51856).

PII: S0002-9343(04)00755-7

doi:10.1016/j.amjmed.2004.12.005

The American Journal of Medicine
Volume 118, Issue 6 , Pages 584-591, June 2005