How can you prevent ventilator-induced lung injury (VILI)?

Using lung-protective strategies is the most effective approach to prevent ventilator-induced lung injury (VILI). These strategies typically involve setting lower tidal volumes and maintaining appropriate airway pressures to minimize overdistension of alveoli and reduce the risk of barotrauma and volutrauma. This approach emphasizes the importance of mechanical ventilation that prioritizes the preservation of lung function and prevents further injury to already compromised lung tissue.

Lung-protective strategies include the use of smaller tidal volumes (generally around 6-8 mL/kg of predicted body weight) and adjusting the positive end-expiratory pressure (PEEP) settings to optimize oxygenation while protecting lung physiology. This method is aligned with evidence-based practices shown to improve outcomes in patients with acute respiratory distress syndrome (ARDS) and other conditions that lead to VILI.

Employing such strategies not only protects the lungs from mechanical injury during ventilation but also aids in improving ventilation-perfusion matching and overall patient outcomes. In contrast, increasing tidal volumes, reducing oxygen levels, or extending patient sedation may not provide the same level of protective benefit and could potentially exacerbate existing lung injuries.