Traditionally, controlled mechanical ventilation via an artificial airway has been provided to completely unload the patient from the work ofbreathing and to assure adequate gas exchange during the acute phase of respiratory insufficiency until the underlying respiratory dysfunction has resolved . Discontinuation of mechanical ventilation is determined mainly by clinical and often subjective judgment or standardized weaning protocols and is accomplished with partial ventilatory support supplementing spontaneous breathing or T-tube trials. Not surprisingly, gradual discontinuation with partial ventilatory support has been shown to be only beneficial in patients with difficulties in tolerating unassisted spontaneous breathing. Although introduced as weaning techniques, partial ventilatory support modes have become standard techniques for primary mechanical ventilatory support in more and more intensive care units (ICUs).
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