Basic ventilator management: Lung protective strategies

Acute respiratory failure is manifested clinically as a patient with variable degrees of respiratory distress, but characteristically an abnormal arterial blood partial pressure of oxygen or carbon dioxide. The application of mechanical ventilation in this setting can be life saving. An emerging body of clinical and basic research, however, has highlighted the potential adverse effects of positive pressure ventilation. Clinicians involved with the care of critically ill patients must recognize and seek to prevent these complications using lung-protective ventilation strategies. This article discusses the basic concepts of mechanical ventilation, reviews the categories of ventilator-associated lung injury and discusses current strategies for the recognition and prevention of these adverse effects in the application of mechanical ventilation.