Basics of mechanical ventilation for non-aneasthetists. Part 2: Clinical aspects

Adv Respir Med. 2020;88(6):580-589. doi: 10.5603/ARM.a2020.0159.

Abstract

Invasive and non-invasive mechanical ventilation (MV) continues to be the most significant life support method. It is, however, coupled with many risks. Historically, concepts of MV did focus on improving the arterial blood gas results rather than preventing harmful side-effects of positive pressure ventilation. Since then, multiple studies exploring this matter emerged and led to the protective MV concept. The golden mean between assuring the best oxygenation and limiting the ventilator-induced lung injury (VILI) is still a matter of debate. These considerations are especially impactful while treating patients with adult respiratory distress syndrome (ARDS), where the limitation of MV's negative effect is specifically important. This paper explores the protective ventilation concept and clinical implications of the latter.

Keywords: acute respiratory distress syndrome; invasive ventilation; mechanical ventilation; non-invasive ventilation; protective ventilation; ventilator-induced lung injury.

MeSH terms

  • Continuous Positive Airway Pressure / methods
  • Humans
  • Pulmonary Ventilation / physiology*
  • Respiration, Artificial / methods*
  • Respiratory Distress Syndrome / therapy*
  • Respiratory Mechanics / physiology
  • Ventilator-Induced Lung Injury / prevention & control*