Advanced modes of mechanical ventilation: implications for practice.

Mechanical ventilation is one of the most commonly applied interventions in intensive care units. Despite its life-saving role, mechanical ventilation is associated with additional risks to the patient and additional healthcare costs if not applied appropriately. To decrease risk, new ventilator modes continue to be developed with the goal of improving patient outcomes. Advances in ventilator modes include dual control modes that enable guaranteed tidal volume and inspiratory pressure, pressure-style modes that permit spontaneous breathing at high- and low-pressure levels, and closed-loop systems that facilitate ventilator manipulation of variables based on measured respiratory parameters. Clinicians need to develop a thorough understanding of these modes including their effects on underlying respiratory physiology to be able to deliver safe and appropriate patient care.