Current Aspects of Respiratory Management for Critically Ill Patients in the Intensive Care Unit

  • Kemmotsu Osamu
    Department of Anesthesiology, Kitasato University School of Medicine (Intensive Care Unit, Kitasato University Hospital), Sagamihara,Japan
  • Soma Kazui
    Department of Internal Medicine, Kitasato University School of Medicine (Intensive Care Unit, Kitasato University Hospital), Sagamihara,Japan

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Description

Mechanical ventilation is mandatory for respiratory management of critically ill patients in the intensive care unit. To gurantee delivery of a preset tidal volume, a ventilatory system should adapt automatically to changes in airway resistance and lung compliance. Although the functional characteristics of conventional ventilator systems have not changed during the last 30 years, several new techniques in ventilatory care have been developed. They are positive end-expiratory pressure (PEEP), intermittent mandatory ventilation (IMV) and high-frequency ventilation (HFV). The use of noninvasive imaging techniques is a recent advance in diagnosis of pulmonary lesions, including chest trauma. Bronchoscopic pulmonary lavage utilizing a flexible bronchofiberscope is beneficial for both diagnosis and treatment of pulmonary diseases. Brief comments on recent aspects of respiratory care in the intensive care unit were described together with presentasions of some informative cases such as asthma, pulmonary contusion, pulmonary thromboembolism and pneumocystis carinii infection.

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