Closed-loop Control in Mechanical Ventilation
In the 1960s and the 1970s, control and assist volume controlled modes were the state-of-the-art for mechanical Ventilation. The aim was to maintain normal gas exchange and blood gas values. By the end of the 1970s, most clinieians realized the importance to allow the patients to breath spontaneously between the controlled respiratory cycles. Intermittent mandatory Ventilation (IMV) as the first available partial mode was received enthusiastieally . The aim shifted from normal gas exchange to maintain normal conditioning of the respiratory muscles, and to increase the patient’s chances of rapid weaning. The 1980s introduced microprocessors, demand flow system, and extensive monitoring into the design of Ventilators. These new technologies updated pressure control modes. The aim became to reduce the patient’s work of breathing and to minimize pulmonary barotrauma. Partial ventilatory support and pressure control mode became widely recommended even during the acute phase of respiratory failure . In most critically ill patients, partial ventilatory support is preferable to füll support for several reasons: First, the patient adapts himself to the respirator, determines his own breathing pattern and requires less or no sedation; second, the decrease in intrapleural pressure, associated with spontaneous inspiratory activity, increases cardiac Output and consequently oxygen delivery; and third, atrophy of the respiratory muscles and diaphragm is likely avoided.
KeywordsCatheter Dioxide Titration Respiration Resi
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