The use of low tidal volume (4-8 ml/kg of predicted body weight) has been considered the default way to ventilate patients with acute respiratory distress syndrome (ARDS) to minimize ventilator-induced lung injury (VILI).

Recommendations have additionally been made to use 6 ml/kg of predicted body weight as a standard setting due to the reason that ARDS can go unrecognized approximately 40% of the time.

It is possible that the driving pressure resulting from the tidal volume, not the tidal volume itself, determines the risk of lung injury and mortality in patients with ARDS.

A recent study published in the American Journal of Respiratory and Critical Care by Ewan Goligher and colleagues assessed the benefits of using a lower tidal volume strategy.

They investigated the relationship of tidal volume and driving pressure on mortality in an interesting and intuitive way using respiratory system elastance normalized to predicted body weight.

Read More