Ventilator-induced lung injury

Most criticalists will passionately debate that “putting a patient on the ventilator” is not a death sentence. But it is well documented that positive pressure ventilation (PPV) can cause significant pathology in the lung and can worsen lung dysfunction already present. Much research in the area, experimentally in animal models and clinically in people, has led to strategies designed to limit the amount of damage caused directly, or indirectly, by the ventilator. This chapter serves to review the pathophysiology and the clinical relevance of VILI and give an introduction to preventative measures. This chapter does not review effects of PPV on other organ systems, such as the cardiovascular system or neuroendocrine system, or other complications related to PPV such as ventilator-associated pneumonia