Recent advances in mechanical ventilation
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
© 2005 Elsevier Inc. All rights reserved.

