![]() Or, more specifically: do we really know what tidal volume we are administering to the lungs our patients, especially in our neonatal and infant populations? The advances in ventilator technology raise the question whether we, as clinicians, still understand how we are ventilating our patients. ![]() Multiple sensors and at least one computer processor is controlled by advanced software algorithms that deliver the breath air and oxygen that these devices deliver. The time of the iron lung or basic ventilators has passed and transitioned into an era of highly sophisticated ventilators on our pediatric intensive care units (PICUs). Mechanical ventilators are more and more frequently becoming computer-driven devices. In our search for the optimal TV for lung-protective ventilation, such choices should be taken into account. Design choices in both the hardware and software of mechanical ventilators can have a clinically relevant impact on the measurement of tidal volume. It showed, as example, a clinically significant impact of 8% difference in reported TV. A software change of the TV measuring algorithm of the SERVO-i ® (Getinge, Solna, Sweden) at the PICU of the University Medical Centre Utrecht was studied in a prospective cohort. Such choice may impact the measurement and subsequent display of TV. Ventilator manufacturers make various design choices regarding the phase, site and conditions of TV measurement as well as algorithmic processing choices. ![]() Tidal volume (TV) is one of the corner stones of ventilation: multiple technical factors influence the TV and, thus, influence clinical decision making. A good understanding of the design of mechanical ventilators can improve clinical care. These technical advancements have impact on clinical decisions in pediatric intensive care units (PICUs). Mechanical ventilators are increasingly evolving into computer-driven devices.
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