Indications for nonconventional ventilation modes

Critical care physicians facing patients that require invasive mechanical ventilation are confronted with the questions what type of ventilator and what ventilator strategy is most appropriate for this particular patient. Mechanical ventilation is initiated to bridge a gap to recovery or to supply chronic support. Failure of mechanical ventilation can arise through inability to deliver adequate gas exchange or through resulting complications, like pneumothorax. Although mechanical ventilation is meant to support respiratory function, mechanical ventilation can also result in pulmonary damage and contribute to increased risk of mortality. Therefore, the selection of the ventilator type and strategy should be guided by the capacity to achieve adequate gas exchange and, in the meanwhile, to prevent lung injury.