Options for ventilating the pediatric patient. Part 1. Mechanical properties of three generations of ventilators.

The past 20 years have seen striking changes in ventilators for use in infants and children. Early in this period, we relied on traditional machines and techniques that were largely borrowed from adult medicine. The availability of second-generation machines brought better understanding of pulmonary physiology, particularly as it relates to oxygen transport. Today, third-generation ventilators very different from the others have forced abandonment of dogma concerning the manner in which molecules of gas enter and leave the lung. Their full impact cannot yet be judged, but they have shown great clinical promise and no doubt will change further our understanding of pulmonary physiology.