Adaptive Support Ventilation: An Inappropriate Mechanical Ventilation Strategy for Acute Respiratory Distress Syndrome?

Sülemanji, Demet; Kacmarek, Robert M.

doi:10.1097/aln.0b013e3181d77574

Cited by 12 publications

(20 citation statements)

References 5 publications

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“…37 Initial data suggest that this mode works well in some patients. 38,39 But, like all of these modes, additional research is needed to identify when it should be used.…”

Section: Fourth-generation Icu Ventilatorsmentioning

confidence: 99%

The Mechanical Ventilator: Past, Present, and Future

Kacmarek

2011

Respir Care

129

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The use of ventilatory assistance can be traced back to biblical times. However, mechanical ventilators, in the form of negative-pressure ventilation, first appeared in the early 1800s. Positivepressure devices started to become available around 1900 and today's typical intensive care unit (ICU) ventilator did not begin to be developed until the 1940s. From the original 1940s ventilators until today, 4 distinct generations of ICU ventilators have existed, each with features different from that of the previous generation. All of the advancements in ICU ventilator design over these generations provide the basis for speculation on the future. ICU ventilators of the future will be able to integrate electronically with other bedside technology; they will be able to effectively ventilate all patients in all settings, invasively and noninvasively; ventilator management protocols will be incorporated into the basic operation of the ventilator; organized information will be presented instead of rows of unrelated data; alarm systems will be smart; closed-loop control will be present on most aspects of ventilatory support; and decision support will be available. The key term that will be used to identify these future ventilators will be smart!

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“…37 Initial data suggest that this mode works well in some patients. 38,39 But, like all of these modes, additional research is needed to identify when it should be used.…”

Section: Fourth-generation Icu Ventilatorsmentioning

confidence: 99%

The Mechanical Ventilator: Past, Present, and Future

Kacmarek

2011

Respir Care

129

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“…48 The allure of IMV lives on in 2016 under other names: adaptive support ventilation, airway pressure release ventilation, and biphasic ventilation, modes that my colleague has described as potentially advantageous. 6,[49][50][51] Each of these is just another method to exploit the advantages of spontaneous breathing outside the IMV brand.…”

Section: A Question Of Intentmentioning

confidence: 99%

Should Intermittent Mandatory Ventilation Be Abolished?

Kacmarek

Branson

2016

Respiratory Care

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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. Key words: Mechanical ventilation, intermittent mandatory ventilation, synchronized intermittent mandatory ventilation, asynchrony and work of breathing. [Respir Care 2016;61(6):854 -866.

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“…the benefits of building models when constructing DSS systems, reflecting on the contribution of this work and the need for further research. 4 …”

Section: Introductionmentioning

confidence: 99%

“…In the intensive Care unit, and in particular in the control of mechanical ventilation, representation of heuristic reasoning can be seen currently as the most successful approach to providing decision support. This approach has produced systems which have both been tested in multi-center randomized control trials [1,2,3,4], and commercialized [1,4].…”

Section: Introductionmentioning

confidence: 99%