In this issue of Clinics in Chest Medicine, guest editors Drs. Gustavo A. Cortes-Puentes and John J. Marini bring their considerable expertise to the topic of Mechanical Ventilation and Ventricular Assist Devices. Leading experts provide in-depth discussions on intubation in the critically ill: when, how, and how long?; sedation, analgesia, and neuromuscular blockade; airflow obstruction and dynamic hyperinflation; extracorporeal gas exchange: indications and implementation; and more.