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July 2, 2008

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

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.