2023 Volume 43 Issue 3 Pages 238-244
Mechanical ventilation played a crucial role in the development of intensive care medicine. Prevention of ventilator-associated lung injury（VALI）is the most important aim in patients with acute respiratory failure. VALI is produced by overdistention or shear stress of alveoli, where transpulmonary pressure is the clinical key index in managing patients with spontaneous breathing. Administering muscle relaxants may be required in patients with strong breathing efforts to avoid VALI. However, muscular atrophy may develop as a side effect of muscle relaxants. The knowledge and experience of acute respiratory failure have been tested in managing patients with COVID-19. Anesthesiologists should keep playing a central role in intensive care medicine.
