A lung-protective approach to ventilating ARDS

A convincing and internally consistent body of literature now suggests that the traditional high tidal volume, normoxic, normacapnic ventilation paradigm may retard healing of the acutely injured lung. A growing number of practitioners are now shifting first priority from optimizing gas exchange, oxygen delivery, or respiratory system compliance to ensuring adequate lung protection. This article reviews the basis for concern about traditional ventilatory support in ARDS and develops an approach based on current evidence and newer options for management.