Why Intermittent Mandatory Ventilation (IMV) Fails?

Abstract

Since the introduction of intermittent mandatory ventilation (IMV) to adult medical practice in 1973, the technique has been fraught with numerous difficulties.(1) Initially, IMV was felt to be purely a weaning tool. Subsequently, as clinicians at the University of Florida began treating patients with severe respiratory failure with IMV, many other clinicians felt that the technique was being used to prematurely discontinue mechanical ventilatory support of critically ill patients.(2,3) Subsequent publications from the University of Florida, the University of Miami, Lackland Air Force Base and other institutions, attempted to support the physiologic basis for allowing spontaneous respiration to persist during mechanical ventilatory support. Initially, the technique did not enjoy wide-spread acceptance. As time as passed, the reasons for this lack of acceptance have become obvious and, in spite of continued controversy, the technique now is applied world-wide.(4,5)