Commentary

Protective ventilation of patients with acute respiratory distress syndrome

Claudia C dos Santos¹ and Arthur S Slutsky²

¹Clinical Associate and Post-Doctoral Fellow, Interdepartmental Division of Critical Care Medicine, and Department of Medicine, University of Toronto, Toronto, and Department of Critical Care Medicine, St Michael's Hospital, Toronto, Ontario, Canada

²Vice President, Research, Department of Critical Care Medicine, St Michael's Hospital, Toronto, Ontario, Canada

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Critical Care 2004, 8:145-147doi:10.1186/cc2849

Published:	23 April 2004

Abstract

In a recent issue of the British Journal of Anaesthesia, Moloney and Griffiths reviewed clinically pertinent issues surrounding the management of the acute respiratory distress syndrome (ARDS) patient, particularly as it pertains to the treatment of ventilator induced/associated lung injury (VILI). In addition to highlighting the important observations that have contributed to further our understanding of the relationship between the mechanical ventilator and inflammatory lung injury, the authors also offer a concise reappraisal of the clinical strategies used to minimize VILI in ARDS. Special emphasis is placed on the theory of biotrauma, which attempts to explain how multi-organ failure may develop in patients who ultimately succumb to this syndrome.