[Certain aspects of continuous ventilation]

The indication of mechanical ventilation is either a failing ventilatory function of the thorax or a failing gas exchange function of the lung. The ventilation affects every organ function in more or less degree. The starting point of long term ventilation is debated, arbitrary. Some ventilatory devices are simulating the natural intrapleural negative pressure principle, but most of them applies intermittent positive pressure into the lung. For improving oxygenation, a moderate level of positive end expiratory pressure, eventually inversed or 1:1 inspiratory:expiratory ratio can be applied. The computerized electronic ventilators offer a big selection of assisting and controlling ventilatory modes, according to the requirements of the patients. For routine use, in ventilatory failure, pressure cycled controlled ventilation, in gas exchange failure, the combination of synchronized intermittent mandatory ventilation, positive end-expiratory pressure and pressure support can be recommended. For special tasks there are existing special ventilatory or other supportive means. In most of the cases some sedation of the ventilated patients is appropriate, muscle paralysing is restricted to a few situations. It is important to humidify the inhaled air. The detailed monitoring of the patients is essential during ventilation. The weaning of the patients from the ventilator is a complex procedure, which involves ventilatory, nutritional, pharmacologic and psychologic interventions.