1. Variability in Mechanical Ventilation: What's All the Noise About?
- Author
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Charles G. Durbin, Carl Lynch, and Bhiken I. Naik
- Subjects
Pulmonary and Respiratory Medicine ,ARDS ,Respiratory rate ,Quantitative Biology::Tissues and Organs ,medicine.medical_treatment ,Physics::Medical Physics ,Critical Care and Intensive Care Medicine ,Positive-Pressure Respiration ,Correspondence ,Tidal Volume ,medicine ,Humans ,Lung ,Tidal volume ,Mechanical ventilation ,Stochastic Processes ,business.industry ,General Medicine ,Stochastic resonance (sensory neurobiology) ,Mechanics ,respiratory system ,medicine.disease ,respiratory tract diseases ,Pulmonary Alveoli ,Noise ,medicine.anatomical_structure ,Anesthesia ,Respiratory Mechanics ,Breathing ,business - Abstract
Controlled mechanical ventilation is characterized by a fixed breathing frequency and tidal volume. Physiological and mathematical models have demonstrated the beneficial effects of varying tidal volume and/or inspiratory pressure during positive-pressure ventilation. The addition of noise (random changes) to a monotonous nonlinear biological system, such as the lung, induces stochastic resonance that contributes to the recruitment of collapsed alveoli and atelectatic lung segments. In this article, we review the mechanism of physiological pulmonary variability, the principles of noise and stochastic resonance, and the emerging understanding that there are beneficial effects of variability during mechanical ventilation.
- Published
- 2015
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