Author Affiliation: Division of Pulmonary and Critical Care Medicine, Harborview Medical Center, Seattle, Wash.
The concept of ventilator-induced lung injury (VILI) has come of age.
The concept that the manner in which patients with acute lung injury and the
acute respiratory distress syndrome (ARDS) have been supported with conventional
mechanical ventilation is responsible for worsening the extent of the lung
injury has been suggested by compelling animal model data.1- 7
However, justification for this concept in human studies is limited to 1 relatively
small randomized controlled trial in which reducing tidal volume decreased
28-day mortality, but hospital discharge mortality was not affected.8 Other studies in which the tidal volume is limited
have had negative results.9,10
Without further evidence in humans, it seemed possible that VILI would prove
to be yet another hypothesis based on animal model data that was not confirmed
in humans. Now, exciting news from studies in humans suggests that VILI is
a clinically relevant process.
Hudson LD. Progress in Understanding Ventilator-Induced Lung Injury. JAMA. 1999;282(1):77-78. doi:10.1001/jama.282.1.77