title: Beyond low tidal volumes: ventilating the patient with acute respiratory distress syndrome.
abstract: The cornerstone of lung protective ventilation in patients with acute respiratory distress syndrome (ARDS) is a pressure- and volume-limited strategy. Other interventions have also been investigated. Although no method for positive end-expiratory pressure (PEEP) titration has proven most advantageous, experimental and clinical data support the use of higher PEEP in patients with moderate/severe ARDS. There is no benefit to the early use of high-frequency oscillatory ventilation (HFOV) in patients with moderate/severe ARDS, although it may be considered as rescue therapy. Further investigations of novel methods of bedside monitoring of mechanical ventilation may help identify the optimal ventilatory strategy.
authors.affiliation: Interdepartmental Division of Critical Care Medicine, University of Toronto, Toronto, Ontario, Canada.
authors.forename: Ray
authors.initials: R
authors.lastname: Guo
authors.affiliation: Interdepartmental Division of Critical Care Medicine, University of Toronto, Toronto, Ontario, Canada. Electronic address: eddy.fan@uhn.ca.
authors.forename: Eddy
authors.initials: E
authors.lastname: Fan
mesh_terms: D006801:Humans; D008991:Monitoring, Physiologic; D012121:Respiration, Artificial / Q000379:methods*; D012128:Respiratory Distress Syndrome / Q000503:physiopathology / Q000628:therapy*; D013990:Tidal Volume
keywords: Acute respiratory distress syndrome; Lung protective ventilation; Mechanical ventilation; Positive end expiratory pressure