Optimizing Mechanical Ventilation by Bedside Lung Monitoring Systems in Critically ill Patients

__Abstract__ Since the original description of the acute respiratory distress syndrome (ARDS) in the Lancet by Ashbaugh et al. in 1967, numerous studies have aimed to improve mechanical ventilation in order to prevent the associated ventilatorinduced lung injury (VILI). In 2000, the landmark study of the ARDSnet group demonstrated that the application of tidal volumes of 6 ml/kg body weight resulted in a reduced mortality rate. This is now widely implemented as ‘protective ventilation’, not only in ARDS patients, but also in mechanically ventilated patients on both the operation room and the intensive care unit (ICU). Descriptions of ‘assisted’ ventilation can be found over the centuries. The first reports of negative and positive pressure mechanical ventilation appeared in the early 1800s. In those days, the negative pressure ventilator was the modality most frequently used. This was first described in 1838 by John Dalziel, a Scottish physician. The patient was placed in sitting position in an airtight box, with only the head left outside. Subsequently, air was manually pumped in and out of the box to change the pressure within the box and in the patient’s thoracic cage, thereby expanding the lungs while the patient was ab