Lésions induites par la ventilation mécanique: Quelles leçons pour le clinicien?

Mechanical ventilation is often required to support patients with severe respiratory failure. This life saving support is not without complications. Mechanical ventilation can cause lung injury by different mechanisms: barotrauma, volutrauma, atelectrauma and biotrauma. Understanding those mechanisms is important and required to implement a lung protective ventilatory strategy at the bedside. Moreover, it has recently been demonstrated that such strategy may contribute to improve outcome in patients with acute lung injury or ARDS, independently of its effect on gas exchange. The goal of this review is to summarise for the clinicians our current understanding of ventilator-induced lung injury and to propose an updated ventilatory strategy for ARDS patients.