Mechanical ventilation

Abstract

Positive-pressure ventilation as we know it came into its own during the polio epidemics of the 1950s.1 Since that time, the use of mechanical ventilatory support has been synonymous with the growth of critical care medicine. Early ventilation used neuromuscular blocking agents to suppress spontaneous respiratory effort. Today, patient-ventilator interaction is understood to be crucial, and there is a growing awareness of complications associated with neuromuscular blockade.2 Finally, there is increasing recognition that ventilators can induce various forms of lung injury, which has led to reappraisal of the goals of ventilatory support.3 Although it seems that each manufacturer of mechanical ventilators has introduced differing modes of mechanical ventilation, fundamental principles of ventilator management of critically ill patients remain unchanged. © 2008 Springer New York.