[Indications for artificial ventilation in status asthmaticus, adult respiratory distress syndrome and pneumonia].

Mechanical ventilation is indicated in acute respiratory failure, especially in so-called pump failure as occurs in status asthmaticus, pneumonia and ARDS due to respiratory muscle fatigue. Using clinical parameters (inspiratory paradox, respiratory alternans), together with blood gas analysis and chest X-ray morphology, the indication can be established on a rational basis. The aims of therapy are tissue oxygenation and cure of the underlying disease which has led to respiratory failure. By adapting ventilator settings to the respiratory mechanics of the individual patient, complication due to barotrauma can be avoided. Respiratory muscle rest can be assessed by monitoring tracheal pressure time curves. Unconventional methods using very small t idal volumes and very high frequency so far have no clearcut indications, as they are still investigational.