From state-of-the-art ventilation to closed loop ventilation

Recent emphasis on energy load delivered during each ventilatory breath has opened a new insight to reduce harmful ventilatory induced lung injury, but no robust clinical evidence of patient benefit produced yet. Closed loop ventilation is a strategy to adjust respiratory support using physiological feedback data obtained for each delivered cycle of respiratory support. Dependent on the model assumption used, closed loop ventilation aims to identify the ideal combination of tidal volume size, reduced driving pressure or respiratory frequency ultimately reducing the energy loading of the lung. This review aims to discuss the current state-of-the-art ventilation concepts and their integration in closed loop ventilation.