Treatment of the patient in the ICU and especially the patient on the ventilator requires a multidisciplinary approach.The intensivist, the physician, the nurses and the physiotherapists, ALL , play a wonderful cohesive role in ensuring a positive outcome for the patients. As physicians involved with the patients in the ICU , managing the patient on the ventilator is a major challenge we face. Ventilator-associated pneumonia (VAP) is a leading cause of mortality in critically ill patients. The threat of emergent septicaemia is another scrooge we have to deal with.

The emerging concepts for care of the patient on the ventilator are interesting and are sure to improve the care of these patients. Automated mapping of lung sound distribution is a novel area of interest currently investigated in mechanically ventilated, critically ill patients. A significant shift in sound distribution from the apical to the diaphragmatic lung areas can be  recorded when increasing PEEP. In patients with unilateral lung pathology, this shift was significant in the sick lung, but not as pronounced in the other lung.

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