Ten reasons to be more attentive to patients when setting the ventilator

Excerpt

Unlike spontaneous breathing or negative pressure ventilation like the one provided by iron lungs, mechanical ventilation used today is a form of externally assisted ventilation that delivers positive pressure throughout the respiratory cycle. Our means of setting ventilators are far from optimal and most recent advances on mechanical ventilation have involved mitigation of its side effects, especially ventilator-induced lung injury. Given the disease and delirium that weaken his/her physical and psychic status, the patient is often unable to indicate the best adjustment done by the clinician. Misak has reported a personal view on her critical care experience while she was intubated [1]. “I was a psychological mess and should not have been taken to be fit to participate in decisions”. We wish, however, to detail ten reasons why we should be more attentive to the patient when setting the ventilator, once he/she has recovered his/her spontaneous breathing (Table 1). …