ABSTRACT
Conventional ventilators remain the mainstay of ICU respiratory support, but there are some significantly different methods of ventilation which are occasionally used, usually as ‘rescue therapies’ when disease (usually ARDS) deteriorates despite optimal conventional ventilation. Modes discussed in this chapter are
■ extracorporeal membrane oxygenators (ECMO) ■ extracorporeal carbon dioxide removal (ECCO2R) ■ intravenous oxygenators (IVOX) ■ high frequency ventilation (HFV), especially oscillatory (HFOV) and jet
(HFJV) ■ liquid ventilation (perfluorocarbon – PFC) ■ hyperbaric oxygenation
although availability is often confined to specialist units. Alveolar recovery is optimised if
■ inflated sufficiently to prevent further atelectasis ■ movement is minimised (low tidal volumes, to minimise volutrauma) ■ overdistension (high peak inflation pressures – barotrauma) is avoided.
