Applied respiratory physiology: use of ventilator waveforms and mechanics in the management of critically ill patients

Abstract

Graphical waveforms have become ubiquitous in clinical care. Using and understanding pictures and symbols is a daily activity. Humans are neurologically equipped to understand symbolic information and have done so for millennia. Cave drawings are examples of using images to convey information. The same approach used in understanding "art" is needed to use ventilator waveforms effectively. Didactic study, frequent viewing, and understanding of the background of the artist (artistic context) are needed to fully appreciate art. Using waveforms to care for patients requires understanding of the clinical context under which they are obtained, factors that affect their creation, and artifacts that interfere with interpretation. This article summarizes the presentation and discussions at this Journal Conference on ventilator waveforms in relation to lung and chest wall compliance, resistance, carbon dioxide kinetics, hemodynamics, specific modes of ventilation, specific lung diseases, and ventilator-weaning.