The fundamental goals of mechanical ventilation are to improve pulmonary gas exchange and relieve respiratory distress, thus permitting lung and airway healing, while at the same time lessening the risk for iatrogenic complications. This review will summarize some of the advances in mechanical ventilation in 2016, with a particular focus on ventilator-associated clinical challenges and outcomes.
TobinMJ. Mechanical ventilation. N Engl J Med, 1994; 330(15):1056–1061.
2.
ColiceGL. Historical perspective on the development of mechanical ventilation. In: TobinMJ, editor. Principles and practice of mechanical ventilation, 3rd edition. New York: McGraw Hill Medical; 2012:3–41.
3.
EstebanA, AnzuetoA, AlíaI, GordoF, ApezteguíaC, PálizasF, et al. How is mechanical ventilation employed in the intensive care unit? An international utilization review. Am J Respir Crit Care Med, 2000; 161(5):1450–1458.
4.
ARDS Definition Task Force, RanieriVM, RubenfeldGD, ThompsonBT, FergusonND, CaldwellE, et al. Acute respiratory distress syndrome: the Berlin Definition. JAMA, 2012; 307(23):2526–2533.
5.
BellaniG, LaffeyJG, PhamT, FanE, BrochardL, EstebanA, et al. Epidemiology, patterns of care, and mortality for patients with acute respiratory distress syndrome in intensive care units in 50 countries. JAMA, 2016; 315(8):788–800.
6.
AmatoMB, MeadeMO, SlutskyAS, BrochardL, CostaEL, SchoenfeldDA, et al. Driving pressure and survival in the acute respiratory distress syndrome. N Engl J Med, 2015; 372(8):747–755.
7.
KlompasM, LiL, KleinmanK, SzumitaPM, MassaroAF. Associations between ventilator bundle components and outcomes. JAMA Intern Med, 2016; 176(9):1277–1283.
8.
GershengornHB, ScalesDC, KramerA, WunschH. Association between overnight extubations and outcomes in the intensive care unit. JAMA Intern Med, 2016; 176(11):1651–1660.
9.
The Acute Respiratory Distress Syndrome Network. Ventilation with lower tidal volumes as compared with traditional tidal volumes for acute lung injury and the acute respiratory distress syndrome. N Engl J Med, 2000; 342(18):1301–1308.
10.
RepesséX, CharronC, Vieillard-BaronA. Acute cor pulmonale in ARDS: rationale for protecting the right ventricle. Chest, 2015; 147(1):259–265.
BellaniG, LaffeyJG, PhamT, MadottoF, FanE, BrochardL, et al. Noninvasive ventilation of patients with acute respiratory distress syndrome: insights from the LUNG SAFE Study. Am J Respir Crit Care Med, 2017; 195(1):67–77.
13.
YoshidaT, RoldanR, BeraldoMA, TorsaniV, GomesS, De SantisRR, et al. Spontaneous effort during mechanical ventilation: maximal injury with less positive end-expiratory pressure. Crit Care Med, 2016; 44(8):e678–e688.
14.
PapazianL, ForelJM, GacouinA, Penot-RagonC, PerrinG, LoundouA, et al. Neuromuscular blockers in early acute respiratory distress syndrome. N Engl J Med, 2010; 363(12):1107–1116.
15.
FrerichsI, AmatoMB, van KaamAH, TingayDG, ZhaoZ, GrychtolB, et al. Chest electrical impedance tomography examination, data analysis, terminology, clinical use and recommendations: consensus statement of the TRanslational EIT developmeNt stuDy group. Thorax, 2017; 72(1):83–93.
16.
CortesGA, MariniJJ. Two steps forward in bedside monitoring of lung mechanics: transpulmonary pressure and lung volume. Crit Care, 2013; 17(2):219.
17.
BellaniG, PesentiA. Assessing effort and work of breathing. Curr Opin Crit Care, 2014; 20(3):352–358.
18.
ZambonM, GrecoM, BocchinoS, CabriniL, BeccariaPF, ZangrilloA. Assessment of diaphragmatic dysfunction in the critically ill patient with ultrasound: a systematic review. Intensive Care Med, 2017; 43(1):29–38.
19.
ZambonM, BeccariaP, MatsunoJ, GemmaM, FratiE, ColomboS, et al. Mechanical ventilation and diaphragmatic atrophy in critically ill patients: an ultrasound study. Crit Care Med, 2016; 44(7):1347–1352.
20.
NetoAS, HemmesSN, BarbasCS, BeiderlindenM, Fernandez-BustamanteA, FutierE, et al. Association between driving pressure and development of postoperative pulmonary complications in patients undergoing mechanical ventilation for general anaesthesia: a meta-analysis of individual patient data. Lancet Respir Med, 2016; 4(4):272–280.
21.
GirardisM, BusaniS, DamianiE, DonatiA, RinaldiL, MarudiA, et al. Effect of conservative vs conventional oxygen therapy on mortality among patients in an intensive care unit: the oxygen-ICU randomized clinical trial. JAMA, 2016; 316(15):1583–1589.
22.
WangCH, ChangWT, HuangCH, TsaiMS, YuPH, WangAY, et al. The effect of hyperoxia on survival following adult cardiac arrest: a systematic review and meta-analysis of observational studies. Resuscitation, 2014; 85(9):1142–1148.
23.
StubD, SmithK, BernardS, NehmeZ, StephensonM, BrayJE, et al. Air versus oxygen in ST-segment-elevation myocardial infarction. Circulation, 2015; 131(24):2143–2150.
24.
PanwarR, HardieM, BellomoR, BarrotL, EastwoodGM, YoungPJ, et al. Conservative versus liberal oxygenation targets for mechanically ventilated patients: a pilot multicenter randomized controlled trial. Am J Respir Crit Care Med, 2016; 193(1):43–51.
25.
GirardTD, AlhazzaniW, KressJP, OuelletteDR, SchmidtGA, TruwitJD, et al. An official American Thoracic Society/American College of Chest Physicians clinical practice guideline: liberation from mechanical ventilation in critically ill adults: rehabilitation protocols, ventilator liberation protocols, and cuff leak tests. Am J Respir Crit Care Med, 2017; 195(1):120–133.
26.
BosmaKJ, ReadBA, Bahrgard NikooMJ, JonesPM, PriestapFA, LewisJF. A pilot randomized trial comparing weaning from mechanical ventilation on pressure support versus proportional assist ventilation. Crit Care Med, 2016; 44(6):1098–1108.
27.
FaisyC, MezianiF, PlanquetteB, ClavelM, GacouinA, BornstainC, et al. Effect of acetazolamide vs placebo on duration of invasive mechanical ventilation among patients with chronic obstructive pulmonary disease: a randomized clinical trial. JAMA, 2016; 315(5):480–488.
28.
MossM, Nordon-CraftA, MaloneD, Van PeltD, FrankelSK, WarnerML, et al. A randomized trial of an intensive physical therapy program for patients with acute respiratory failure. Am J Respir Crit Care Med, 2016; 193(10):1101–1110.
29.
MorrisPE, BerryMJ, FilesDC, ThompsonJC, HauserJ, FloresL, et al. Standardized rehabilitation and hospital length of stay among patients with acute respiratory failure: a randomized clinical trial. JAMA, 2016; 315(24):2694–2702.
