Principles of mechanical ventilator use in respiratory failure

Recent advances in our knowledge of the pathophysiology of acute and chronic respiratory failure have significantly revised our strategies for ventilatory support. Gas exchange, muscle function, barotrauma, and the course and prognosis of the mechanically ventilated patient are now better understood. Furthermore, impressive technological innovations have enabled the clinician to monitor patient-ventilator interactions closely and to undertake ventilatory approaches unthought of only a short time ago. The purpose of this review is to highlight key management principles and therapeutic options that derive from our improved understanding of respiratorv failure and its treatment.