RT Book, Section A1 Al-Hegelan, Mashael A1 MacIntyre, Neil R. A2 Hall, Jesse B. A2 Schmidt, Gregory A. A2 Kress, John P. SR Print(0) ID 1107718568 T1 Novel Modes of Mechanical Ventilation T2 Principles of Critical Care, 4e YR 2015 FD 2015 PB McGraw-Hill Education PP New York, NY SN 9780071738811 LK accessanesthesiology.mhmedical.com/content.aspx?aid=1107718568 RD 2024/10/10 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.