• C Hörmann and H Benzer.
• Klinik für Anästhesie und Allgemeine Intensivmedizin, Universität Innsbruck.
• Wien. Klin. Wochenschr. 1994 Jan 1; 106 (13): 407-11.

AbstractIn spontaneous breathing intrathoracic pressure alternates between positive and negative in a biphasic sequential pattern. By contrast, during mechanical ventilation (IPPV, CPPV) the intrathoracic pressure remains above atmospheric all the time. Due to these unphysiological conditions there are extensive causal and side effects on the lung parenchyma and other organs. Errors in the artificial ventilation technique can magnify these effects. In order to minimize these deleterious effects of positive pressure ventilation it is essential to keep the procedure as short and little invasive as possible. The following strategy enables this goal to be brought closer: 1) early commencement of ventilation; 2) optimal adjustment of artificial ventilation to the individual needs of the patient, 3) early weaning from assisted ventilation through augmented rather than controlled modes of ventilation: 4) kinetic therapy (systematic changing of the patient's position) with the back up of the requisite thoracic CT scan findings; 5) reduction of the invasiveness of the procedure in order to ensure early commencement of spontaneous respiration.

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