We do not need mechanical ventilation any more

Mechanical ventilation is a lifesaving treatment delivered to patients with a wide spectrum of medical and surgical diseases. However, significant limitations of the clinical application of mechanical ventilation in current practice have emerged, prompting the definition of novel therapeutic perspectives, especially concerning the prevention and treatment of acute respiratory failure. In the past few decades, there has been a consistent scientific and technologic effort to develop alternative strategies to avoid the need for mechanical ventilation. In particular, several studies have explored the feasibility and efficacy of extracorporeal oxygenation and carbon dioxide removal. Furthermore, promising results on the prevention of the occurrence of severe acute respiratory failure have been provided by clinical studies on the noninvasive application of continuous positive airway pressure as well as by experimental investigations in basic science. Therefore, further development in this direction will occur only with a permanent integration and exchange of knowledge among industry, clinicians, and scientific investigators. (Crit Care Med 2010; 38[Suppl.]:S555-S558)