10年前提出的间歇指令式通气(Intermittent mandatory ventilation,IMV)被认为是机械通气技术的一个重大突破,当时流行的是控制式或辅助式。控制式机械通气(Controlled mechanical ventilation,CMV)是在一个固定的时间间隔里输出正压呼吸,它不能使人工呼吸与病人自主呼吸的周期同步,也不允许病人的呼吸超过规定的频率。这对麻醉和昏迷的病人很适用,而清醒的病人为了达到同步和舒适,常需使用镇静剂和肌肉松弛剂。辅助式机械通气(Assisted mechanicol ventilation,AMV)是另一种改革的呼吸机。使用AMV的病人进行自主呼吸时,引起气道压力变化,使呼吸器作出正压呼吸的反应。所以,病人是在自己呼吸节律的基础上接受AMV的。大多数情况下,使用AMV都可以达到呼吸同步化,并可 Intermittent mandatory ventilation (IMV), introduced 10 years ago, is considered a major breakthrough in mechanical ventilation technology when it became prevalent, either controlled or assisted. Controlled mechanical ventilation (CMV) is a positive pressure breath output at a fixed time interval that does not allow artificial respiration to be synchronized with the patient’s spontaneous breathing cycle or to allow the patient’s breath to exceed the prescribed frequency. This applies to anesthetized and unconscious patients, whereas conscious patients often need to use sedatives and muscle relaxants for synchronization and comfort. Assisted mechanicol ventilation (AMV) is another reform of the ventilator. In patients who use AMV to breathe spontaneously, they cause changes in airway pressure, causing the ventilator to respond positively to breathing pressure. Therefore, the patient is receiving AMV on the basis of his breathing rhythm. In most cases, breath synchronization can be achieved using AMV and can be