Abstract
Mechanical ventilation has evolved over the last number of years from a hit-or-miss strategy to one based on physiologic endpoints. The acceptance of higher levels of PaCO2 generated by permissive hypercapnia and lower minute volumes coupled with various new microprocessor-controlled ventilators has begun to have an impact on patient outcome. These ventilators have led to the evolution of various pressure-governed modes: pressure-controlled inverse ratio ventilation, pressure-regulated volume control, proportional assist ventilation, and airway pressure release ventilation. Hypercapnia is now being controlled with the use of tracheal gas insufflation, which can be added to any mode of pressure-governed ventilation. Clin Pulm Med 1995;2(2):121-128
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