Basic concepts in mechanical ventilation

Mechanical ventilatory support is a major component of the clinical management of critically ill patients admitted into intensive care. Closely linked with the developments within critical care medicine, the use of ventilatory support has been increasing since the polio epidemics in the 1950s (Lassen 1953). Initially used to provide controlled mandatory ventilation, today with advances in technology, most mechanical ventilators are triggered by the patient, increasing the awareness of the complexity of patient/ventilator interaction (Tobin 1994). Though ventilator appearance and design may have changed quite significantly and the variety of options for support extensive, the basic concepts of mechanical ventilatory support of the critically ill patient remains unchanged. This paper aims to outline these concepts so as to gain a better understanding of mechanical ventilatory support.