title: Variability in Mechanical Ventilation: What's All the Noise About?
abstract: Controlled mechanical ventilation is characterized by a fixed breathing frequency and tidal volume. Physiological and mathematical models have demonstrated the beneficial effects of varying tidal volume and/or inspiratory pressure during positive-pressure ventilation. The addition of noise (random changes) to a monotonous nonlinear biological system, such as the lung, induces stochastic resonance that contributes to the recruitment of collapsed alveoli and atelectatic lung segments. In this article, we review the mechanism of physiological pulmonary variability, the principles of noise and stochastic resonance, and the emerging understanding that there are beneficial effects of variability during mechanical ventilation.
authors.affiliation: Department of Anesthesiology, University of Virginia, Charlottesville, Virginia. bin4n@virginia.edu.
authors.forename: Bhiken I
authors.initials: BI
authors.lastname: Naik
authors.affiliation: Department of Anesthesiology, University of Virginia, Charlottesville, Virginia.
authors.forename: Carl
authors.initials: C
authors.lastname: Lynch
authors.affiliation: Department of Anesthesiology, University of Virginia, Charlottesville, Virginia.
authors.forename: Charles G
authors.initials: CG
authors.lastname: Durbin
mesh_terms: D006801:Humans; D008168:Lung / Q000503:physiopathology; D011175:Positive-Pressure Respiration / Q000379:methods*; D011650:Pulmonary Alveoli / Q000503:physiopathology; D015656:Respiratory Mechanics / Q000502:physiology; D013269:Stochastic Processes; D013990:Tidal Volume / Q000502:physiology
keywords: ARDS; noise; recruitment; stochastic resonance; variability