• Critical care clinics · Jan 2002

    Review

    Mechanical ventilation in acute lung injury and ARDS. Tidal volume reduction.

    • Roy G Brower.
    • Department of Pulmonary and Critical Care Medicine, Johns Hopkins University, Baltimore, Maryland, USA.
    • Crit Care Clin. 2002 Jan 1; 18 (1): 1-13, v.

    AbstractTraditional mechanical ventilation practices used generous tidal volumes in patients with acute lung injury and acute respiratory distress syndrome (ALI/ARDS). This approach may have caused overdistention of aerated lung units, thus exacerbating lung injury in some patients. Several recent clinical trials of traditional versus lower tidal volume strategies in ALI/ARDS yielded disparate results. In the largest study, the lower tidal volume approach was associated with lower mortality and more ventilator-free days. This article reviews the rationale for tidal volume reduction in ALI/ARDS and the differences between the studies. Several different interpretations of the recent clinical trial results are addressed.

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