Inverse Ratio Ventilation with Pressure Control

Recent interest in newer ventilatory support modes has been stimulated by the fact that the only thing we can offer the patient with severe acute respiratory failure (ARF) is to buy time and allow the lung to heal by itself. The mortality from acute adult respiratory distress syndrome (ARDS) has changed little since the first description in 1967 by Ashbaugh et al. However, there seems to be mounting evidence that high peak pressures (Ppeak) and high fractions of inspired oxygen (FiO2) should be avoided as this would add further injury to an already compromised lung (Taghizadeh and Reynolds 1976; Kolobow et al. 1987; Denek and Fanburg 1980; Pratt et al. 1979).