A few things I have learned and you should know.

Mechanical ventilation is an interesting thing, and I have discovered that its being shown that we should have soft music playing for patients who are being ventilated; it improves outcomes[1].  Respiratory therapists as a profession need to expand our practice to being a lot more bed-side and directly involved in the patients outcomes because in our current state, we are struggling to constantly prove our necessity while simultaneously delegating our scope to the bedside clinicians[2].  Oh yeah, and there are only four (4) modes of mechanical ventilation, the rest are all brand-names that represent a strategy within one of those four modes[3]. Lactic acid is a good indicator that the patient is not being ventilated well enough and their work of breathing has increased, in addition to the typical pH balance measurements[4].  I also have far too much free time.

1. Hunter BC, Oliva R, Sahler OJ, Gaisser D, Salipante DM, Arezina CH (2010)  Music therapy as an adjunctive treatment in the management of stress for patients being weaned from mechanical ventilation. ''J Music Ther'' 47 (3):198-219. PMID: 21275332
2. Rose L (2010) Clinical application of ventilator modes: Ventilatory strategies for lung protection. ''Aust Crit Care'' 23 (2):71-80. DOI:10.1016/j.aucc.2010.03.003 PMID:  20378369
3. Preferred Nomenclature for Mechanical Ventilation for Manuscripts Submitted to RESPIRATORY CARE (2011). On the web: AARC.org
4. Marjanović V, Dordević V, Marjanović G (2009) Oxidative stress in patients on mechanical ventilation. ''Med Pregl'' 62 (11-12):578-81. PMID: 20491385