Effect of Ventilator Settings on Mechanical Power During Simulated Mechanical Ventilation of Patients With ARDS.

Background: In recent years, mechanical power (MP) has emerged as an important concept that can significantly impact outcomes from mechanical ventilation. Several individual components of ventilatory support such as tidal volume (V), breathing frequency, and PEEP have been shown to contribute to the extent of MP delivered from a mechanical ventilator to patients in respiratory distress/failure. The aim of this study was to identify which common individual setting of mechanical ventilation is more efficient in maintaining safe and protective levels of MP using different modes of ventilation in simulated subjects with ARDS.

Advanced modes of mechanical ventilation and optimal targeting schemes.

Recent research results provide new incentives to recognize and prevent ventilator-induced lung injury (VILI) and create targeting schemes for new modes of mechanical ventilation. For example, minimization of breathing power, inspiratory power, and inspiratory pressure are the underlying goals of optimum targeting schemes used in the modes called adaptive support ventilation (ASV), adaptive ventilation mode 2 (AVM2), and MID-frequency ventilation (MFV). We describe the mathematical models underlying these targeting schemes and present theoretical analyses for minimizing tidal volume, tidal pressure (also known as driving pressure), or tidal power as functions of ventilatory frequency.