Controlled mechanical ventilation is characterized by a fixed breathing frequency and tidal volume. Physiological and mathematical models have demonstrated the beneficial effects of varying tidal volume and/or inspiratory pressure during positive-pressure ventilation. The addition of noise (random changes) to a monotonous nonlinear biological system, such as the lung, induces stochastic resonan...

During mechanical ventilation for acute respiratory distress syndrome, tidal volume (VT) must be reduced. Once switched to pressure-support ventilation, there is a risk that uncontrolled large VT may be delivered. A 63-year-old man with community-acquired pneumonia required tracheal intubation and mechanical ventilation, with a VT of 6 mL/kg predicted body weight, PEEP of 10 cm H2O, a respirato...

During mechanical ventilation for acute respiratory distress syndrome, tidal volume (V(T)) must be reduced. Once switched to pressure-support ventilation, there is a risk that uncontrolled large V(T) may be delivered. A 63-year-old man with community-acquired pneumonia required tracheal intubation and mechanical ventilation, with a V(T) of 6 mL/kg predicted body weight, PEEP of 10 cm H2O, a res...

PURPOSE Right internal jugular vein (RIJV) catheterisation is a common procedure in patients undergoing surgery. We aimed to compare diameters and the cross-sectional area (CSA) of the RIJV when the head is in a neutral or 30-degree rotated position during mechanical ventilation in various modes and spontaneous ventilation. METHODS Thirty patients undergoing surgery were included in the study...

BACKGROUND Previous bench studies suggest that dynamic hyperinflation may occur if intrapulmonary percussive ventilation (IPV) is superimposed on mechanical ventilation in volume controlled continuous mandatory ventilation (VC-CMV) mode. We tested the hypothesis that pressure controlled continuous mandatory ventilation (PC-CMV) can protect against this risk. METHODS An ICU ventilator was conn...

T he timing of tracheal extubation after open heart surgery may accelerate recovery without increasing mortality. However, the manner of weaning from controlled mechanical ventilation (CMV) varies widely in different centers. Since 1972 an alternative means of ventilatory “support” advocated is that of intermittent mandatory ventilation ( IMV), in which an inadequate minute volume produced by t...

The first generation of mechanical ventilators were controlled and cycled by pressure. Unfortunately, they did not allow control of the delivered tidal volume under changes in the dynamics of the respiratory system. This led to a second generation of ventilators that allowed volume control, hence favoring the ventilatory strategy based on normalization of the arterial gases. Studies conducted i...

UNLABELLED In this study we evaluated whether a technology based on artificial neural networks (ANN) could estimate the static compliance (C(RS)) of the respiratory system, even in the absence of an end-inspiratory pause, during continuous mechanical ventilation. A porcine model of acute lung injury was used to provide recordings of different respiratory mechanics conditions. Each recording con...

Most patients undergoing surgical procedures need to be mechanically ventilated, because of the impact of several drugs administered at induction and during maintenance of general anaesthesia on respiratory function. Optimization of intraoperative mechanical ventilation can reduce the incidence of post-operative pulmonary complications and improve the patient's outcome. Preoxygenation at induct...

Acute respiratory distress syndrome (ARDS) is an acute hypoxemic respiratory failure with lung oedema of non cardiac origin. Its primary treatment is mechanical ventilation. ARDS is under the spotlights with influenza A pandemic flu. An operating definition has been set out by an experts-consensus conference in order to include patients in clinical trials. However, this definition lacks diagnos...