The advent of conventional mechanical ventilation marked a milestone in the care of critically ill patients, enabling respiratory supplementation and improving survival for those infirmed from both medical and surgical illness. Subsequent investigation has enlightened us to the physiology and even pathophysiology of ventilatory support, facilitated the development of alternate modes of conventional ventilation, and identified those situations for which each is most suitable. Despite such advances, the pulmonary pathology of many patients necessitates support beyond which conventional mechanical ventilation can provide. Such situations are encountered in the preterm infant failing surfactant replacement for whom only ECMO offers any hope, and in the patient with Acute Respiratory Distress Syndrome (ARDS). Furthermore, recent evidence suggests that traditional large tidal volume mechanical ventilation in patients with ARDS is detrimental and may contribute to the pulmonary dysfunction. Hence, newer modes of providing respiratory support are needed.
KeywordsSurfactant Dioxide Hydrocarbon Fluorine Pneumothorax
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