• J López-Herce Cid and A Carrillo Alvarez.
• Sección de Cuidados Intensivos Pediátricos. Hospital General Universitario Gregorio Marañón, Madrid, Spain. pielvi@retemail.es
• An Pediatr (Barc). 2003 Jul 1;59(1):95-102.

AbstractIn the last few years new mechanical ventilation modalities have been developed that aim to improve the characteristics of mechanical ventilation and its adaptation to the patient. Volume-programmed and pressure-controlled ventilation (volume-controlled pressure-adjusted, adaptable pressure ventilation, autoflow ventilation) attempt to combine the advantages of volume and pressure ventilation by controlling volume but with decelerated flow. These types of ventilation can be programmed in controlled, assisted, intermittent mandatory ventilation, or support ventilation mode. Other modalities offer pressure ventilation with continuous flow during the respiratory cycle (BIPAP, DUOPAP, APRV) and allow the patient to breathe spontaneously. Some ventilators have new modalities (adaptable support ventilation) that calculate the best minute ventilation according to the patient's weight and the level of support required. The ventilator provides support according to spontaneous respiratory frequency and tidal volume. Other modalities (proportional assist ventilation) provide support according to the patient's respiratory efforts. These new modalities can improve the adaptation of mechanical ventilation to the patient. None of these modalities are superior to the others. The choice of ventilation mode should be individualized according to each patient's characteristics.

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