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A Journal on Anesthesiology, Resuscitation, Analgesia and Intensive Care

Official Journal of the Italian Society of Anesthesiology, Analgesia, Resuscitation and Intensive Care
Indexed/Abstracted in: Current Contents/Clinical Medicine, EMBASE, PubMed/MEDLINE, Science Citation Index Expanded (SciSearch), Scopus
Impact Factor 2,036

Frequency: Monthly

ISSN 0375-9393

Online ISSN 1827-1596


Minerva Anestesiologica 2005 June;71(6):255-8

SMART 2005 - Milan, May 11-13, 2005 

Ventilator or physician-induced lung injury?

Villar J.

Research Institute, Hospital Universitario N.S. of Candelaria, Tenerife, Spain Adjunct Scientist, Research Center St. Michael’s Hospital, Toronto, Ontario, Canada

One of the most challenging problems in critical care medicine is the acute respiratory distress syndrome (ARDS), the most severe form of acute lung injury (ALI). Evidence from experimental studies suggests that mechanical ventilation can cause or aggravate lung injury. Referred to as ventilator-induced lung injury (VILI), this condition resembles ALI and ARDS, and is difficult to identify in humans because its appearance overlaps the underlying disease, supporting the assumption that mechanical ventilation can extend the severity of pre-existent lung injury. There is increasing laboratory evidence that ventilating ARDS models with relatively low tidal volumes and high levels of positive end-expiratory pressure (PEEP) is clinically beneficial. In 2000, the ARDS Network published reported a reduced mortality (from 40% to 31%) in a mixed population of patients with ALI and ARDS ventilated with half the tidal volume of the control group. However, almost forty years after the first description of ARDS, many investigators and experts in the field still apply essentially the same ventilatory strategy (tidal volume greater than 10 mL/kg body weight and PEEP levels less than 10 cmH2O) as in the original description of ARDS.

language: English


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