title: Should Intermittent Mandatory Ventilation Be Abolished?
abstract: Intermittent mandatory ventilation (IMV) was introduced nearly 50 years ago. Despite the initial fanfare and early adoption by many, the role of IMV continues to be questioned. The use of small tidal volumes complicates the application of IMV, and issues with work of breathing, weaning and lack of clear advantages have many calling for a moratorium on its use. Spontaneous breathing, however, has a number of salutatory effects on gas exchange, the distribution of ventilation, and hemodynamics. These issues will be explored in light of a growing body of evidence.
authors.affiliation: Department of Anesthesiology, Harvard Medical School, and Department of Respiratory Care, Massachusetts General Hospital, Boston, Massachusetts. rkacmarek@partners.org Richard.branson@uc.edu.
authors.forename: Robert M
authors.initials: RM
authors.lastname: Kacmarek
authors.affiliation: Department of Surgery, University of Cincinnati, Cincinnati, Ohio. rkacmarek@partners.org Richard.branson@uc.edu.
authors.forename: Richard D
authors.initials: RD
authors.lastname: Branson
mesh_terms: D000818:Animals; D006801:Humans; D007385:Intermittent Positive-Pressure Ventilation / Q000009:adverse effects / Q000379:methods*; D008168:Lung / Q000503:physiopathology*; D012119:Respiration; D012121:Respiration, Artificial / Q000379:methods*
keywords: Mechanical ventilation; asynchrony and work of breathing; intermittent mandatory ventilation; synchronized intermittent mandatory ventilation