Newly Published
Editorial Views  |   March 2019
Mechanical Ventilation in Acute Respiratory Distress Syndrome: Time Heals All Wounds, or Does It?
Author Notes
  • From the Interdepartmental Division of Critical Care Medicine, University of Toronto, Toronto, Ontario, Canada (L.D.S., A.S.S.); University Health Network, Toronto General Hospital, Toronto, Ontario, Canada (L.D.S.); Department of Medicine and Physiology, Mayo Clinic, Rochester, Minnesota (R.H.); Department of Medicine, University of Minnesota, Minneapolis, Minnesota (R.H.); Keenan Research Center, Li Ka Shing Knowledge Institute, St. Michael’s Hospital, Toronto, Ontario, Canada (A.S.S.).
  • Accepted for publication January 27, 2019.
    Accepted for publication January 27, 2019.×
  • Correspondence: Address correspondence to Dr. Slutsky: slutskya@smh.ca
Article Information
Editorial Views
Editorial Views   |   March 2019
Mechanical Ventilation in Acute Respiratory Distress Syndrome: Time Heals All Wounds, or Does It?
Anesthesiology Newly Published on March 12, 2019. doi:10.1097/ALN.0000000000002671
Anesthesiology Newly Published on March 12, 2019. doi:10.1097/ALN.0000000000002671
Acute respiratory distress syndrome (ARDS), characterized by the acute onset of hypoxemia (PaO2/FiO2 less than or equal to 300), bilateral pulmonary radiographic opacities, and diffuse inflammatory-induced pulmonary capillary leakage,1  is a critical public health issue. There are more than three million patients per year with ARDS receiving mechanical ventilation,2  and their mortality rate is very high, ranging from about 30% to 40%.3 
Over the last 25 yr, a substantial body of literature has clearly demonstrated that this high mortality rate is in part attributable to the injurious effects of mechanical ventilation, so-called ventilator-induced lung injury.4  Although significant progress has been made in reducing ventilator-induced lung injury and improving patient outcomes, current lung protective ventilatory strategies may still be associated with high risk of ventilator-induced lung injury, especially in patients with more severe ARDS.5  As such, increased understanding of the pathophysiologic mechanisms mediating ventilator-induced lung injury, through studies such as the one by Felix et al.6  in this issue of the Journal, is important to help design optimal ventilatory strategies,7  and potentially improve outcomes.