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New modes of assisted mechanical ventilation
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Hedenstierna laboratory.
2014 (English)In: Medicina Intensiva, ISSN 0210-5691, E-ISSN 1578-6749, Vol. 38, no 4, 249-260 p.Article in journal (Refereed) Published
Abstract [en]

Recent major advances in mechanical ventilation have resulted in new exciting modes of assisted ventilation. Compared to traditional ventilation modes such as assisted-controlled ventilation or pressure support ventilation, these new modes offer a number of physiological advantages derived from the improved patient control over the ventilator. By implementing advanced closed-loop control systems and using information on lung mechanics, respiratory muscle function and respiratory drive, these modes are specifically designed to improve patient-ventilator synchrony and reduce the work of breathing. Depending on their specific operational characteristics, these modes can assist spontaneous breathing efforts synchronically in time and magnitude, adapt to changing patient demands, implement automated weaning protocols, and introduce a more physiological variability in the breathing pattern. Clinicians have now the possibility to individualize and optimize ventilatory assistance during the complex transition from fully controlled to spontaneous assisted ventilation. The growing evidence of the physiological and clinical benefits of these new modes is favoring their progressive introduction into clinical practice. Future clinical trials should improve our understanding of these modes and help determine whether the claimed benefits result in better outcomes. (C) 2013 Elsevier Espana, S.L. and SEMICYUC. All rights reserved.

Place, publisher, year, edition, pages
2014. Vol. 38, no 4, 249-260 p.
Keyword [en]
Patient-ventilation synchrony, Assisted mechanical ventilation, Work of breathing
National Category
Medical and Health Sciences
URN: urn:nbn:se:uu:diva-227190DOI: 10.1016/j.medin.2013.10.008ISI: 000335715800008OAI: oai:DiVA.org:uu-227190DiVA: diva2:729873
Available from: 2014-06-26 Created: 2014-06-24 Last updated: 2014-06-26Bibliographically approved

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Suarez-Sipmann, Fernando
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