TY - CHAP M1 - Book, Section TI - Ventilator-Induced Lung Injury A1 - Fanelli, Vito A1 - Granton, John T. A1 - Slutsky, Arthur S. A2 - Hall, Jesse B. A2 - Schmidt, Gregory A. A2 - Kress, John P. Y1 - 2015 N1 - T2 - Principles of Critical Care, 4e AB - Ventilator-induced lung injury (VILI) may occur with both lung volumes that lead to overdistention of lung units (volutrauma) or with low distending pressures that allow the lung to be recruited and derecruited (atelectrauma).VILI may cause injury in previously healthy regions of lung, and may also lead to multiorgan dysfunction.To reduce the risk of VILI, limitation of end-inspiratory stretch using low tidal volumes ∼6 mL/kg and limiting plateau pressure (Pplat) <30 cm H2O should be used in treating most patients with acute lung injury (ALI) or acute respiratory distress syndrome (ARDS). Higher Pplat may be used in patients with poorly compliant chest walls.The appropriate level of positive end-expiratory pressure remains to be determined, but levels of PEEP that minimize atelectasis may be beneficial.Permissive hypoventilation (hypercapnia) may be a necessary component of a lung-protective ventilator strategy.The penetrance of lung-protective ventilation strategies into clinical practice is improving. SN - PB - McGraw-Hill Education CY - New York, NY Y2 - 2024/10/12 UR - accessanesthesiology.mhmedical.com/content.aspx?aid=1107718649 ER -