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Continuing Education in Anaesthesia, Critical Care & Pain 2005 5(4):113-117; doi:10.1093/bjaceaccp/mki031
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Continuing Education in Anaesthesia, Critical Care & Pain | Volume 5 Number 4 2005 © The Board of Management and Trustees of the British Journal of Anaesthesia [2005]. All rights reserved. For Permissions, please email: journals.permissions@oupjournals.org

Weaning from mechanical ventilation

Jeremy Lermitte, BM FRCA, Specialist Registrar in Anaesthesia
Intensive Care Unit, Ipswich Hospital NHS Trust, Heath Road, Ipswich, IP4 5UL

Mark J Garfield, MB ChB FRCA, Consultant in Anaesthesia and Intensive Care Medicine
Intensive Care Unit, Ipswich Hospital NHS Trust, Heath Road, Ipswich, IP4 5UL
Tel: 01473 702016, Fax: 01473 702323. E-mail: mark.garfield{at}doctors.org.uk (for correspondence)

Mechanical ventilation has gone through a dramatic evolution over a relatively short space of time. After the Copenhagen polio epidemic in 1952, negative pressure ‘iron lungs’ were replaced by intermittent positive pressure ventilation. This was originally delivered at set volumes and rates. The next step forward was the introduction of intermittent mandatory ventilation, and shortly thereafter this was synchronized to the patient's respiratory effort. More recently, pressure support ventilation and bi-level positive airway pressure modes have become available. Modern ventilators are increasingly sensitive, allowing easy patient triggering of supported breaths, modes such as tube compensation, and measurement of numerous respiratory parameters. Developments in weaning techniques have paralleled these improvements in ventilator functionality.


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