• Emerson Seiberlich, Jonas Alves Santana, Renata de Andrade Chaves, and Raquel Carvalho Seiberlich.
• CET/SBA of IPSEMG, Belo Horizonte, Brazil. seiberlich@gmail.com
• Rev Bras Anestesiol. 2011 Sep 1;61(5):659-67, 361-5.

Background And ObjectivesMechanical ventilation (MV) strategies have been modified over the last decades with a tendency for increasingly lower tidal volumes (VT). However, in patients without acute lung injury (ALI) or acute respiratory distress syndrome (ARDS) the use of high VTs is still very common. Retrospective studies suggest that this practice can be related to mechanical ventilation-associated ALI. The objective of this review is to search for evidence to guide protective MV in patients with healthy lungs and to suggest strategies to properly ventilate lungs with ALI/ARDS.ContentsA review based on the main articles that focus on the use of strategies of mechanical ventilation was performed.ConclusionsConsistent studies to determine which would be the best way to ventilate a patient with healthy lungs are lacking. Expert recommendations and current evidence presented in this article indicate that the use of a VT lower than 10 mL.kg(-1), associated with positive end-expiratory pressure (PEEP) ≥ 5 cmH(2)O without exceeding a pressure plateau of 15 to 20 cmH(2)O could minimize alveolar stretching at the end of inspiration and avoid possible inflammation or alveolar collapse.Copyright © 2011 Elsevier Editora Ltda. All rights reserved.

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