Is there a best way to set tidal volume for mechanical ventilatory support?
Tidal breaths are an important component of mechanical ventilation. However, an inappropriate tidal volume setting can overstretch and injure the lung. Maximal stretch, tidal stretch, frequency of stretch, and rate of stretch are all implicated in such injury. Clinical trials have shown that limiting maximal and tidal stretch improves outcomes, even if gas exchange is partially compromised. Thus, current strategies should focus on limiting tidal and maximal stretch as much as possible.
MacIntyre
Neil R
NR
Division of Pulmonary and Critical Care Medicine, Duke University Medical Center, Room 1120, Box 3911, Erwin Road, Durham, NC 27710, USA. neil.macintyre@duke.edu
D006801:Humans; D008168:Lung / Q000502:physiology; D011659:Pulmonary Gas Exchange; D012121:Respiration, Artificial; D013990:Tidal Volume