Conventional Mechanical Ventilation

  • Joseph D. Tobias


The support of infants and children with respiratory failure or insufficiency is one of the most common techniques or procedures performed in the Pediatric Intensive Care Unit (PICU). Before the 1930s, respiratory failure was uniformly fatal due to the lack of equipment and techniques for airway management and ventilatory support. The first widespread use of mechanical support for respiratory failure began with negative pressure ventilation during the poiliomyelitis epidemics of the 1930’s. The operating rooms of the 1950s and 1960s provided the arena for the development of the manual skills and the refinement of the equipment needed for airway management, which subsequently led to the more widespread of endotracheal intubation thereby ushering in the era of positive pressure ventilation.


Tidal Volume Pressure Support Positive Pressure Ventilation Plateau Pressure Peak Inspiratory Pressure 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

Suggested Readings

  1. Banner MJ, Kirby RR, Blanch PB, Layton AJ. Decreasing imposed work of breathing apparatus to zero using pressure-support ventilation. Crit Care Med. 1993;21:1333–8.PubMedCrossRefGoogle Scholar
  2. Brochard L, Harf A, Lorino H, Lemaire F. Inspiratory pressure support prevents diaphragmatic fatigue during weaning from mechanical ventilation. Am Rev Respir Dis. 1989;139:513–21.PubMedCrossRefGoogle Scholar
  3. Brochard L, Rauss A, Benito S, et al. Comparison of three methods of gradual withdrawal from ventilatory support during weaning from mechanical ventilation. Am J Respir Crit Care Med. 1994;150:896–900.PubMedGoogle Scholar
  4. Cohen IL, Bilen Z, Krishnamurthy S. The effects of ventilator working pressure during pressure support ventilation. Chest. 1993;103:588–92.PubMedCrossRefGoogle Scholar
  5. Dammann JF, McAslan TC. PEEP: its use in young patients with apparently normal lungs. Crit Care Med. 1979;7:14–9.PubMedCrossRefGoogle Scholar
  6. Deans KJ, Minneci PC. Mechanical ventilation in ARDS: one size does not fit all. Crit Care Med. 2005;33:1141–3. and comment in Crit Care Med 2006;34:264–7.PubMedCrossRefGoogle Scholar
  7. Esteban A, Frutos F, Tobin MJ, et al. A comparison of four methods of weaning from mechanical ventilation. Spanish lung failure collaborative group. N Engl J Med. 1995;332:345–50.PubMedCrossRefGoogle Scholar
  8. Hammon Jr JW, Wolfe WG, Moran JF, Jones RH, Sabiston Jr DC. The effect of positive end-expiratory pressure on regional ventilation and perfusion in the normal and injured primate lung. J Thorac Cardiovasc Surg. 1976;72:680–5.PubMedGoogle Scholar
  9. Keenan HT, Martin LD. Volume support ventilation in infants and children: analysis of a case series. Respir Care. 1997;42:281–5.Google Scholar
  10. Khan N, Brown A, Venkataraman ST. Predictors of extubation success and failure in mechanically ventilated infants and children. Crit Care Med. 1996;24:1568–79.PubMedCrossRefGoogle Scholar
  11. Leith DE, Bradley M. Ventilatory muscle strength and endurance training. J Appl Physiol. 1976;41:508–16.PubMedGoogle Scholar
  12. MacIntyre NR, Leatherman NE. Mechanical loads on the ventilatory muscles: a theoretical analysis. Am Rev Respir Dis. 1989;139:968–73.PubMedGoogle Scholar
  13. Marini JJ, Gattinoni L. Ventilatory management of acute respiratory distress syndrome: a consensus of two. Crit Care Med. 2004;32:250–5.PubMedCrossRefGoogle Scholar
  14. Matamis D, Lemaire F, Harf A, Brun-Buisson C, Anquer JC, Atlan G. Total respiratory pressure-volume curves in the adult respiratory distress syndrome. Chest. 1984;86:58–62.PubMedCrossRefGoogle Scholar
  15. Newth CJL, Venkataraman S, Willson D, et al. Weaning and extubation readiness in pediatric patients. Pediatr Crit Care Med. 2009;10:1–11.PubMedCrossRefGoogle Scholar
  16. Petros AJ, Fernando SS, Shenoy VS, Al-Saady NM. The Hayek oscillator. Nomograms for tidal volume and minute ventilation using external high frequency oscillation. Anaesthesia. 1995;50: 601–6.PubMedCrossRefGoogle Scholar
  17. Petrucci N, Iacovelli M. Ventilation with smaller tidal volumes: a quantitative systematic review of randomized controlled trials. Anesth Analg. 2004;99:193–200.PubMedCrossRefGoogle Scholar
  18. Randolph AG, Wjpii D, Vankataraman ST, et al. Effect of mechanical ventilator weaning protocols on respiratory outcomes in infants and children. JAMA. 2002;288:2561–8.PubMedCrossRefGoogle Scholar
  19. Schuster S, Weilemann LS, Kelbel C, Schinzel H, Meyer J. Inverse ration ventilation improves pulmonary gas exchange and systemic oxygen transport in patients with congestive heart failure. Clin Intensive Care. 1991;2:148–53.Google Scholar
  20. Siempos II, Vardakas KZ, Kopterides P, Falagas ME. Impact of passive humidification on clinical outcomes of mechanically ventilated patients: a meta-analysis of randomized controlled trials. Crit Care Med. 2007;35(12):2843–51.PubMedCrossRefGoogle Scholar
  21. Smith TS, Marini JJ. Impact of PEEP on lung mechanics and work of breathing in severe airflow obstruction. J Appl Physiol. 1988;65:1488–99.PubMedGoogle Scholar
  22. Suter PM, Fairley HB, Isenberg MD. Optimum end expiratory airway pressure in patients with acute pulmonary failure. N Engl J Med. 1975;292:284.PubMedCrossRefGoogle Scholar
  23. Suter PM, Fairley HB, IsenBerg MD. Effect of tidal volume and positive end-expiratory pressure on compliance during mechanical ventilation. Chest. 1978;73:158–62.PubMedCrossRefGoogle Scholar
  24. Thomson A. The role of negative pressure ventilation. Arch Dis Child. 1997;77:454–8.PubMedCrossRefGoogle Scholar
  25. Tuxen DV. Detrimental effects of positive end-expiratory pressure during controlled mechanical ventilation of patients with severe airflow obstruction. Am Rev Respir Dis. 1989;140:5–9.PubMedCrossRefGoogle Scholar
  26. Weisman IM, Rinaldo JE, Rogers RM, Sanders MH. Intermittent mandatory ventilation. Am Rev Respir Dis. 1983;127:641.PubMedGoogle Scholar
  27. Wyszogrodski I, Kyei-Aboagye K, Taeusch Jr HW, Avery ME. Surfactant inactivation by hyperventilation: conservation by end-expiratory pressure. J Appl Physiol. 1975;38:461–7.PubMedGoogle Scholar
  28. Yang KL, Tobin MJ. A prospective study of indexes predicting the outcome of trials of weaning from mechanical ventilation. N Engl J Med. 1991;324:1445–53.PubMedCrossRefGoogle Scholar

Copyright information

© Springer-Verlag London Limited 2012

Authors and Affiliations

  1. 1.Pediatric Anesthesiology, Department of Anesthesiology & Pain MedicineThe Ohio State University College of Medicine, Nationwide Children’s Hospital ColumbusUSA

Personalised recommendations