Mechanical ventilation (MV) although life-saving, can also be harmful: MV and sedation cause the disused diaphragm muscle to atrophy rapidly and profoundly (ventilator induced diaphragm dysfunction; VIDD*)Positive-pressure ventilation often damages the lungs (ventilator induced lung injury; VILI) and may lead to ventilatorassociated pneumonia (VAP)MV requires intubation and depending on the injury or illness may require a tracheostomy whenever mechanical ventilation has to continue for a longer period of timeVentilated patients are at high risk of contracting nosocomial (hospital-acquired) bacterial and fungal infections.

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