• P E Bollaert.
• Service de Réanimation Médicale, CHU-Hôpital Central-54035 Nancy.
• B Acad Nat Med Paris. 2000 Jan 1;184(8):1643-50; discussion 1651.

AbstractIn recent years, considerable improvement has been achieved in the field of mechanical ventilation. A lot of experimental and clinical research has been done to reduce the adverse effects of mechanical ventilation. It is currently of importance that high volumes and pressures have been demonstrated as sources of alveolar-capillary membrane injury in lungs. In the acute respiratory distress syndrome, mechanical ventilator settings have evolved from the goal of strict correction of gas exchange towards a lung-protective strategy where priority is given to tidal volumes limitation and alveolar recruitment. Pressure-assisted ventilatory modes, such as pressure support have been introduced, resulting in better patient-ventilator synchronisation, good tolerance and easier weaning process. Pressure support is also a largely used mode in noninvasive ventilation which has been proved to improve outcome in chronic obstructive pulmonary diseases.

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