title: [Which kind of therapy for which patient? Choosing the ventilator strategy in ARDS].
abstract: Ventilator-induced lung injury (VILI) contributes to the high mortality of ALI/ARDS. Lung protective ventilation with a tidal volume of 6 ml / kgIBW (Ideal Body Weight) and a plateau pressure <30 cm H2O has shown to reduce mortality and was thus selected as one of ten quality indicators for critical care in Germany. The optimal level of PEEP is currently unclear; however, patients with severe disorders of gas exchange seem to benefit from higher PEEP levels.Adjusting the respirator settings to the mechanical properties of the individual patient will change the treatment of ARDS in the next few years. Measurements of transpulmonary pressure by an oesophageal probe or electrical impedance tomography (EIT) are promising approaches, but still need to proof their superiority. Until then, every clinician must aim to translate the recommendations of lung protective ventilation into daily practice.
authors.affiliation: Klinik für Anästhesiologie mit Schwerpunktoperative Intensivmedizin der Charité-Universitätsmedizin Berlin. lars.toepfer@charite.de
authors.forename: Lars
authors.initials: L
authors.lastname: Töpfer
authors.forename: Steffen
authors.initials: S
authors.lastname: Weber-Carstens
authors.forename: Vera
authors.initials: V
authors.lastname: von Dossow-Hanfstingl
mesh_terms: D006801:Humans; D011175:Positive-Pressure Respiration / Q000379:methods* / Q000639:trends*; D012128:Respiratory Distress Syndrome / Q000175:diagnosis* / Q000534:rehabilitation*