Mechanical ventilation has been part of basic life support for several decades. Several potential drawbacks and complications were identified early in the use of mechanical ventilation [1]. Of these, ventilator-induced lung injury (VILI) has recently received much attention in both the experimental [2] and the clinical field [3-7]. The purpose of this chapter is to review the physiological evidence for VILI based on animal studies and to place these results into a clinical perspective of ventilatory management of acute respiratory distress syndrome (ARDS).

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