TY - CHAP M1 - Book, Section TI - Novel Modes of Mechanical Ventilation A1 - Al-Hegelan, Mashael A1 - MacIntyre, Neil R. A2 - Hall, Jesse B. A2 - Schmidt, Gregory A. A2 - Kress, John P. PY - 2015 T2 - Principles of Critical Care, 4e AB - Mechanical ventilators are support devices, not therapeutic devices. The clinical goal is thus to support gas exchange without causing harm.A number of challenges face clinicians in providing safe and effective mechanical ventilatory support. Two of the most important are (1) supporting gas exchange without causing injury from applied pressure or FiO2; (2) providing comfortable interactive support as the lung recovers.Innovations need to focus on addressing clinical challenges. Moreover, to be accepted as “standard of care,” an innovation must be shown to improve an important clinical outcome.Recent innovations focusing on supporting gas exchange in a “lung protective” fashion include airway pressure release ventilation, high frequency ventilation, and adaptive support ventilation.Recent innovations focusing on improving patient-ventilator synchrony include various feedback controls on variable flow-pressure-targeted breaths, proportional assist ventilation, and neutrally adjusted ventilatory assistance.While all of these innovations have conceptual appeal and supporting observational data, none as yet have convincing randomized control trial data demonstrating improved clinical outcomes. SN - PB - McGraw-Hill Education CY - New York, NY Y2 - 2024/10/03 UR - accessanesthesiology.mhmedical.com/content.aspx?aid=1107718568 ER -