[Mechanical Ventilation].

Mechanical ventilation is a useful treatment option for respiratory insufficiency following thoracic and cardiovascular surgery. Ventilation mode is classified as volume-controlled-ventilation(VCV) and pressure-controlled ventilation(PCV). Non-invasive ventilation(NIV) without tracheal intubation has been recently developed and is effective in patients with chronic obstructive pulmonary disease (COPD) exacerbation. Several pulmonary complications by mechanical ventilation such as ventilator-induced lung injury(VILI) or ventilator-associated pneumonia(VAP) could be avoided with NIV. According to the protocol published from Japanese Society of Intensive Care Unit, Japanese Society of Respiratory Care Medicine, and Japan Academy of Critical Care Nursing, both spontaneous awakening trial(SAT) and spontaneous breathing trial(SBT) are recommended at the weaning from mechanical ventilation. I herein describe the utility of mechanical ventilation in patients with major pulmonary resection, myasthenia gravis, lung transplantation, and cardiac surgery, for each. We should understand not only the utility but also the non-physiological condition during mechanical ventilation.