Ventilatory support for acute respiratory failure: new and ongoing pathophysiological, diagnostic and therapeutic developments.

PURPOSE OF REVIEW: Acute respiratory failure and its most severe form, the acute respiratory distress syndrome, are relatively common in the ICU setting and have a high morbidity and mortality. This article will discuss ongoing research in this area, with a focus on relatively novel approaches in terms of pathophysiology, diagnosis and therapeutic advancements.

RECENT FINDINGS: Several novel diagnostic and therapeutic tools, such as electrical impedance tomography, high frequency oscillatory ventilation, minimally invasive extracorporeal CO2 removal devices and neurally adjusted ventilatory assist, have recently been studied to minimize ventilator-induced lung injury. A brief review of these studies is presented in this article.

SUMMARY: It is increasingly evident that only integration of physiological, clinical and technological approaches will lead to improvement in the outcome of patients with acute respiratory failure.