Optimal ventilator settings in acute lung injury and acute respiratory distress syndrome

Eur J Anaesthesiol. 2008 Feb;25(2):89-96. doi: 10.1017/S0265021507003006. Epub 2007 Nov 16.


Despite recent advances in intensive care medicine, acute lung injury and its more severe form, acute respiratory distress syndrome pose major therapeutic problems. While mechanical ventilation is integral to the care of these patients, its adverse consequences including ventilator-induced lung injury are determinants of disease progression and prognosis. Among several important ventilator parameters, the use of low tidal volumes is probably the most important feature of lung-protective mechanical ventilation. Intensivists should be trained to recognize acute lung injury and acute respiratory distress syndrome and encouraged to use low-tidal-volume ventilation in clinical practice. Alternative modes of ventilation such as high-frequency ventilation and prone position should be reserved for selected patients in whom conventional lung-protective ventilation strategies have failed.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Critical Care / methods
  • Extracorporeal Membrane Oxygenation
  • High-Frequency Ventilation
  • Humans
  • Prone Position
  • Randomized Controlled Trials as Topic / statistics & numerical data
  • Respiration, Artificial / adverse effects
  • Respiration, Artificial / methods*
  • Respiratory Distress Syndrome / therapy*
  • Tidal Volume