TY - JOUR T1 - Variability in Mechanical Ventilation: What's All the Noise About? JF - Respiratory Care DO - 10.4187/respcare.03794 SP - respcare.03794 AU - Bhiken I Naik AU - Carl Lynch III AU - Charles G Durbin, Jr Y1 - 2015/02/17 UR - http://rc.rcjournal.com/content/early/2015/02/17/respcare.03794.abstract N2 - Controlled mechanical ventilation is characterized by a fixed breathing frequency and tidal volume. Physiological and mathematical models have demonstrated the beneficial effects of varying tidal volume and/or inspiratory pressure during positive-pressure ventilation. The addition of noise (random changes) to a monotonous nonlinear biological system, such as the lung, induces stochastic resonance that contributes to the recruitment of collapsed alveoli and atelectatic lung segments. In this article, we review the mechanism of physiological pulmonary variability, the principles of noise and stochastic resonance, and the emerging understanding that there are beneficial effects of variability during mechanical ventilation. ER -