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July 7, 1999

Progress in Understanding Ventilator-Induced Lung Injury

Author Affiliations

Author Affiliation: Division of Pulmonary and Critical Care Medicine, Harborview Medical Center, Seattle, Wash.

JAMA. 1999;282(1):77-78. doi:10.1001/jama.282.1.77

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.