• John J Marini and Luciano Gattinoni.
• University of Minnesota, Regions Hospital, St. Paul 55101, USA. John.j.marini@healthpartners.com
• Crit. Care Med. 2004 Jan 1; 32 (1): 250-5.

ObjectiveTo synthesize the emerging body of experimental, observational, and clinical trial data into a practical guideline for safe and effective ventilatory management of acute respiratory distress syndrome.Data SourcesRelevant, peer-reviewed, scientific literature and personal observations from clinical practice.Study SelectionRelevant experimental studies and high-impact observational and clinical trials of acute respiratory distress syndrome management.Data ExtractionDetailed review of information contained in published scientific work.Data SynthesisInteractive discussions between the authors that culminated in our consensus view of appropriate management.ConclusionsPrevention of ventilator-induced lung injury while accomplishing the essential life-supporting roles of mechanical ventilation is a complex undertaking that requires application of principles founded on a broad experimental and clinical database and on the results of well-executed clinical trials. At the bedside, execution of an effective lung-protective ventilation strategy remains an empirical process best guided by integrated physiology and a readiness to revise the management approach depending on the individual's response.

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