To the Editor: Dr Mercat and colleagues1 reported the results of the Express trial comparing a minimal alveolar distention strategy with a strategy aiming for maximal alveolar recruitment while limiting hyperinflation. Although there was no difference in the primary end point (28-day mortality rate), the maximal alveolar recruitment strategy resulted in more ventilator-free days, more organ failure–free days, and less frequent use of rescue therapy. However, there are certain points that merit attention.
Heunks LMA, van der Hoeven JG. Ventilation Strategies for Acute Lung Injury and Acute Respiratory Distress Syndrome. JAMA. 2008;300(1):39-43. doi:10.1001/jama.300.1.40-b