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Prone ventilation, sometimes called prone positioning or proning, is a method of mechanical ventilation with the patient lying face-down (prone). It improves oxygenation in most patients with acute respiratory distress syndrome (ARDS) and reduces mortality. [1] The earliest trial investigating the benefits of prone ventilation occurred in 1976. [2]
Modes of mechanical ventilation are one of the most important aspects of the usage of mechanical ventilation.The mode refers to the method of inspiratory support. In general, mode selection is based on clinician familiarity and institutional preferences, since there is a paucity of evidence indicating that the mode affects clinical outcome.
There are many modes of mechanical ventilation. [1] In medicine, mechanical ventilation is a method to mechanically assist or replace spontaneous breathing. A breath by breath trigger, limit, cycling (TLC) classification of the common modes of ventilation. (V = ventilator; P = patient) [2]
Acute respiratory distress syndrome was first described in 1967 by Ashbaugh et al. [10] [50] Initially there was no clearly established definition, which resulted in controversy regarding the incidence and death of ARDS. In 1988, an expanded definition was proposed, which quantified physiologic respiratory impairment.
[2] [3] High frequency ventilation is thought to reduce ventilator-associated lung injury (VALI), especially in the context of Acute respiratory distress syndrome (ARDS) and acute lung injury (ALI). [2] This is commonly referred to as lung protective ventilation. [4] There are different types of high-frequency ventilation. [2]
Modes of mechanical ventilation has only had an established nomenclature since 2008. [1] It is suggested that the modes categorized under the following sections be referred to as their section header instead of their individual name, which is often a brand name instead of the preferred nomenclature.
The permissive hypercapnia leads to respiratory acidosis which might have negative side effects, but given that the patient is in ARDS, improving ventilatory function is more important. Since hypoxemia is a major life-threatening condition and hypercapnia is not, one might choose to accept the latter. Hence the term, "permissive hypercapnia."
Continuous mandatory ventilation (CMV) is a mode of mechanical ventilation in which breaths are delivered based on set variables. Still used in the operating room, in previous nomenclature, CMV referred to "controlled mechanical ventilation" ("control mode ventilation"), a mode of ventilation characterized by a ventilator that makes no effort to sense patient breathing effort.