• Julian Kuestermann, Peter Kranke, Jörg Brederlau, Norbert Roewer, and Ralf Michael Muellenbach.
• Klinik und Poliklinik für Anästhesiologie, Universitätsklinikum Würzburg und Mitarbeiter der Arbeitsgruppe Akutes Lungen versagen. kuesterman_j@klinik.uni-wuerzburg.de
• Anasthesiol Intensivmed Notfallmed Schmerzther. 2009 Jun 1;44(6):404-11.

BackgroundLung-protective ventilation strategies for patients suffering from acute lung injury (ALI/ARDS) are well- accepted measures to improve outcome including mortality. But what tidal volume is the best for the patient with non-injured lungs undergoing elective surgery?MethodsWe searched the literature for studies that analysed perioperative tidal volume in patients not suffering from ALI/ARDS.Results10 studies were detected that matched our query. Mostly on patients undergoing major or cardiac surgery.ConclusionOnly a few studies exist which examine the effect of protective ventilation settings on healthy lungs of patients not being critical-ill. The reported results are very heterogeneous and do not strongly support a lung- protective ventilation strategy. However, apart from reasoning based on pre-clinical experimental data, there is some clinical evidence, that suggests using lower tidal volumes in patients undergoing major or cardiac surgery, even if the patient does not present with an ALI/ARDS and is not critically ill at the time when the surgical procedure is performed.

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