Considerable progress has been made recently in the understanding of how best to accomplish safe and effective ventilation of patients with acute lung injury. Mechanical and nonmechanical factors contribute to causation of ventilator-associated lung injury. Intervention timing helps determine the therapeutic efficacy and outcome, and the stage and severity of the disease process may determine the patient's vulnerability as well as an intervention's value. Reducing oxygen consumption and ventilatory demands are key to a successful strategy for respiratory support of acute respiratory distress syndrome. Results from major clinical trials can be understood against the background of the complex physiology of ventilator-induced lung injury.
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The author declares that he has no competing interests. This article has been published as part of Critical Care Volume 19 Supplement 3, 2015: Future of Critical Care Medicine (FCCM) 2014. The full contents of the supplement are available online at http://www.ccforum. com/supplements/19/S3. Publication of this supplement was supported by Fresenius Kabi.
© 2015 Marini.