title: [Mechanical ventilation in the acute lung injury/acute respiratory distress syndrome].
abstract: OBJECTIVE
  The II Brazilian Consensus Conference on Mechanical Ventilation was published in 2000. Knowledge on the field of mechanical ventilation evolved rapidly since then, with the publication of numerous clinical studies with potential impact on the ventilatory management of critically ill patients. Moreover, the evolving concept of evidence - based medicine determined the grading of clinical recommendations according to the methodological value of the studies on which they are based. This explicit approach has broadened the understanding and adoption of clinical recommendations. For these reasons, AMIB - Associação de Medicina Intensiva Brasileira and SBPT - Sociedade Brasileira de Pneumologia e Tisiologia - decided to update the recommendations of the II Brazilian Consensus. Acute Respiratory Distress Syndrome (ARDS) has been one of the updated topics. This objective was described the most important topics related to mechanical ventilation in patients with acute respiratory distress syndrome.
  
  
  METHODS
  Systematic review of the published literature and gradation of the studies in levels of evidence, using the key words mechanical ventilation and acute respiratory distress syndrome.
  
  
  RESULTS
  Recommendations on the use of lung protective strategies during mechanical ventilation based on reduced tidal volumes and limitation of plateau pressure. The state of the art of recruitment maneuvers and PEEP titration is also discussed.
  
  
  CONCLUSIONS
  The mechanical ventilation of patients with ADRS changed in the last few years. We presented the role of lung protective strategies that could be applied to these patients.
authors.affiliation: UTI-Respiratória, Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo, SP.
authors.forename: Marcelo B P
authors.initials: MB
authors.lastname: Amato
authors.affiliation: UTI-Respiratória, Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo, SP.
authors.forename: Carlos R R
authors.initials: CR
authors.lastname: Carvalho
authors.affiliation: Hospital de Clínicas de Porto Alegre, Faculdade de Medicina, Universidade Federal do Rio Grande do Sul, RS.
authors.forename: Sílvia
authors.initials: S
authors.lastname: Vieira
authors.affiliation: Serviço de Terapia Intensiva, Hospital do Servidor Público Estadual de São Paulo, SP.
authors.forename: Alexandre
authors.initials: A
authors.lastname: Isola
authors.affiliation: Unidade de Terapia Intensiva, Hospital Copa D'Or, RJ.
authors.forename: Vivian
authors.initials: V
authors.lastname: Rotman
authors.affiliation: Hospital Estadual Prof. Liberato Di Dio do Grajaú, SP.
authors.forename: Marcelo
authors.initials: M
authors.lastname: Moock
authors.affiliation: Santa Casa de São Paulo.
authors.forename: Anderson
authors.initials: A
authors.lastname: José
authors.affiliation: Hospital das Clínicas, Universidade Federal de Goiás, GO.
authors.forename: Suelene Aires
authors.initials: SA
authors.lastname: Franca