ARDS - Paradigms Lost and Found

Therefore, we inevitably increase tidal volume, driving pressure, and MP in individuals with the most severe lung injury such that these parameters may be associated with, but not causal to, the outcomes in acute lung injury. However, I remember all too well the assumptions that drove the paradigm in which I trained and am in favor of pushing to better understand at the tissue and even cellular level how much ‘volutrauma’ we are causing in individual patients, and testing whether or not new therapeutic ‘targets’ beyond the current ‘6 cc/kg tidal volume’ will enable us to better care for patients with ARDS and improve on the survival gains we have made in the past two decades.