Advantage of spontaneous breathing in patients with respiratory failure

The fact that different modalities of mechanical ventilation are associated with a number of serious side effects and risks and can influence the clinical outcome of patients, the various modes of mechanical ventilation have, over the past ten years, been the subject of a wide variety of scientific studies. Many of these modalities are designed for partial ventilatory support, which might reflect the complexity of the issue of patient’s ventilator interactions when spontaneous breathing activity is present, compared to controlled mechanical ventilation. Spontaneous breathing modes during mechanical ventilation may integrate intrinsic feedback mechanisms that should help prevent ventilator- induced lung injury and improve synchrony between the ventilator and the patient’s demand. The improvements in pulmonary gas exchange, systemic blood flow, and oxygen supply to the tissue that have been observed when spontaneous breathing has been maintained during mechanical ventilation are reflected in the clinical improvement in the patient’ s condition. It is the aim of this article to review the effects of preserved spontaneous breathing activity during mechanical ventilation in patients with acute respiratory failure.