• Gary Nieman, Michaela Kollisch-Singule, Harry Ramcharran, Joshua Satalin, Sarah Blair, Louis A Gatto, Penny Andrews, Auyon Ghosh, David W Kaczka, Donald Gaver, Jason Bates, and Nader M Habashi.
• Department of Surgery, SUNY Upstate Medical Center, SUNY Upstate, 750 East Adams St., Syracuse, NY, 13210, USA.
• Crit Care. 2022 Aug 7; 26 (1): 242.

AbstractA hallmark of ARDS is progressive shrinking of the 'baby lung,' now referred to as the ventilator-induced lung injury (VILI) 'vortex.' Reducing the risk of the VILI vortex is the goal of current ventilation strategies; unfortunately, this goal has not been achieved nor has mortality been reduced. However, the temporal aspects of a mechanical breath have not been considered. A brief expiration prevents alveolar collapse, and an extended inspiration can recruit the atelectatic lung over hours. Time-controlled adaptive ventilation (TCAV) is a novel ventilator approach to achieve these goals, since it considers many of the temporal aspects of dynamic lung mechanics.© 2022. The Author(s).

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