title: Protective mechanical ventilation, why use it?
abstract: OBJECTIVE
  Mechanical ventilation (MV) strategies have been modified over the last decades with a tendency for increasingly lower tidal volumes (VT). However, in patients without acute lung injury (ALI) or acute respiratory distress syndrome (ARDS) the use of high VTs is still very common. Retrospective studies suggest that this practice can be related to mechanical ventilation-associated ALI. The objective of this review is to search for evidence to guide protective MV in patients with healthy lungs and to suggest strategies to properly ventilate lungs with ALI/ARDS.
  
  
  BACKGROUND
  A review based on the main articles that focus on the use of strategies of mechanical ventilation was performed.
  
  
  CONCLUSIONS
  Consistent studies to determine which would be the best way to ventilate a patient with healthy lungs are lacking. Expert recommendations and current evidence presented in this article indicate that the use of a VT lower than 10 mL.kg(-1), associated with positive end-expiratory pressure (PEEP) ≥ 5 cmH(2)O without exceeding a pressure plateau of 15 to 20 cmH(2)O could minimize alveolar stretching at the end of inspiration and avoid possible inflammation or alveolar collapse.
authors.affiliation: CET/SBA of IPSEMG, Belo Horizonte, Brazil. seiberlich@gmail.com
authors.forename: Emerson
authors.initials: E
authors.lastname: Seiberlich
authors.forename: Jonas Alves
authors.initials: JA
authors.lastname: Santana
authors.forename: Renata de Andrade
authors.initials: Rde A
authors.lastname: Chaves
authors.forename: Raquel Carvalho
authors.initials: RC
authors.lastname: Seiberlich
mesh_terms: D055371:Acute Lung Injury / Q000209:etiology* / Q000517:prevention & control*; D006801:Humans; D012121:Respiration, Artificial / Q000009:adverse effects* / Q000379:methods*; D012128:Respiratory Distress Syndrome / Q000628:therapy*