Mechanical ventilation works by applying a positive pressure breath and is dependent on the compliance and resistance of the airway system, which is affected by how much pressure must be generated by the ventilator to provide a given tidal volume (TV). The TV is the volume of air entering the lung during inhalation. Compliance and resistance are dynamic and can be affected by the disease state(s) that led to the intubation. Understanding the changes in compliance and resistance will allow you to pick the proper ventilator strategies. There are four stages of mechanical ventilation. There is the trigger phase, the inspiratory phase, the cycling phase, and the expiratory phase. The trigger phase is the initiation of an inhalation which is triggered by an effort from the patient or by set parameters by the mechanical ventilator. The inhalation of air into the patient defines the inspiratory phase. The cycling phase is the brief moment when inhalation has ceased but before exhalation has begun. The expiratory phase is the passive exhalation of air from the patient. Once the decision is made to place a patient on mechanical ventilation, the clinician may be presented with multiple different options on how to set up the ventilator.  There are many kinds of modes of ventilation, such as assist-control (AC), synchronized intermittent mechanical ventilation (SIMV), and pressure support ventilation (PSV). The ventilator can then be set to provide a given volume or pressure.  Several leading voices in emergency medicine and critical care recommend utilizing volume assist control (VAC) as it is simple to use, safe, and available on all ventilators. This information can be published in our peer reviewed journal with impact factors and are calculated using citations not only from research articles but also review articles (which tend to receive more citations), editorials, letters, meeting abstracts, short communications, and case reports. The inclusion of these publications provides the opportunity for editors and publishers to manipulate the ratio used to calculate the impact factor and try to increase their number rapidly. Impact factor plays a major role for the particular journal. Journal with higher impact factor is considered to be more important than other ones.