Abstract
Intermittent mandatory ventilation (IMV) was introduced nearly 50 years ago. Despite the initial fanfare and early adoption by many, the role of IMV continues to be questioned. The use of small tidal volumes complicates the application of IMV, and issues with work of breathing, weaning and lack of clear advantages have many calling for a moratorium on its use. Spontaneous breathing, however, has a number of salutatory effects on gas exchange, the distribution of ventilation, and hemodynamics. These issues will be explored in light of a growing body of evidence.
- Mechanical ventilation
- intermittent mandatory ventilation
- synchronized intermittent mandatory ventilation
- asynchrony and work of breathing
Footnotes
- Correspondence: Robert M Kacmarek PhD RRT FAARC, Respiratory Care, Warren 1225, Massachusetts General Hospital, 55 Fruit Street, Boston, MA 01460. E-mail: rkacmarek{at}partners.org. Richard D Branson MSc RRT FAARC, University of Cincinnati, 231 Albert Sabin Way, ML #0558, Cincinnati, OH 45267. E-mail: Richard.branson{at}uc.edu.
Dr Kacmarek and Mr Branson presented a version of this paper at the 54th Respiratory Care Journal Conference, “Respiratory Care Controversies III,” held June 5–6, 2015, in St Petersburg, Florida.
Dr Kacmarek has disclosed relationships with Covidien, Orange Medical, and Venner Medical. Mr Branson has disclosed relationships with Bayer, Meiji Pharmaceuticals, Medtronic, Mallinckrodt, Phillips, and Ventec.
↵* Ray Masferrer RRT FAARC, Managing Editor, Respiratory Care.
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