Should A Tidal Volume of 6 mL/kg Be Used in All Patients?

Respir Care. 2016 Jun;61(6):774-90. doi: 10.4187/respcare.04651.


It has been shown that mechanical ventilation by itself can cause lung injury and affect outcomes. Ventilator-induced lung injury is associated with high tidal volumes in lungs afflicted with ARDS. However, the question is: Do high tidal volumes have this same effect in normal lungs or lungs that have respiratory compromise stemming from something other than ARDS? Many clinicians believe that a tidal volume strategy of 6 mL/kg predicted body weight should be standard practice in all patients receiving mechanical ventilation. There is a growing body of evidence related to this issue, and this is the debate that will be tackled in this paper from both pro and con perspectives.

Keywords: ARDS; hypercapnia; lung-protective ventilation; mechanical ventilation; predicted body weight; strain; stress; tidal volume; time constant.

Publication types

  • Review

MeSH terms

  • Humans
  • Lung / physiopathology
  • Respiration, Artificial / standards*
  • Respiratory Distress Syndrome / therapy*
  • Tidal Volume*
  • Ventilator-Induced Lung Injury / prevention & control*