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Mechanical ventilation is the most common life support procedure in the intensive care unit (ICU). 1 It is used in a full spectrum of acute situations, which share the same primary goals: to maintain gas exchange, reduce the work of breathing, and improve patient comfort. Depending on the severity and timing of the patients’ course, mechanical ventilation can fully control and suppress the patients’ respiratory load or be used as partial ventilatory support, that is, preserving spontaneous effort to a certain extent. An ideal delivery of mechanical ventilation would reduce respiratory distress by decreasing excessive respiratory load, while maintaining an appropriate level of spontaneous effort (preventing diaphragm and respiratory muscle atrophy) a Interdepartmental Division of Critical Care Medicine, University of Toronto, St. Michael’s Hospital, 30 Bond Street, Toronto, ON M5B 1W8, Canada; b Keenan Research Centre …