Abstract
A decade after the introduction of lung-protective ventilation strategies with low tidal volumes, the adverse effects of mechanical ventilation remain a scientific and clinical challenge. This situation has fueled the search for adjuvant pharmacological strategies to advance the benefit of protective ventilation in an additive or synergistic manner. In a recent issue of Critical Care, Müller and coworkers demonstrate convincingly that the initiation of high-dose simvastatin treatment prior to the onset of mechanical ventilation can attenuate adverse effects in overventilated mice. The present commentary discusses the need for adjuvant therapy in mechanical ventilation, the scientific rational for statin therapy in this context, and potential limitations for its implementation into clinical practice.
Highlights
A decade after the introduction of lung-protective ventilation strategies with low tidal volumes, the adverse effects of mechanical ventilation remain a scientific and clinical challenge
In a recent issue of Critical Care, Müller and coworkers [1] report the results of an elegant experimental study in which they evaluated the therapeutic potential of highdose simvastatin (20 mg/kg) in overventilated mice
A decade after the landmark studies by Amato and the Acute Respiratory Distress Syndrome Network highlighted the clinical benefit of lung-protective ventilation strategies, the challenge posed by ventilator-induced lung injury (VILI) remains far from resolved
Summary
A decade after the introduction of lung-protective ventilation strategies with low tidal volumes, the adverse effects of mechanical ventilation remain a scientific and clinical challenge. In a recent issue of Critical Care, Müller and coworkers [1] report the results of an elegant experimental study in which they evaluated the therapeutic potential of highdose simvastatin (20 mg/kg) in overventilated mice. The proportion of patients who receive lung-protective ventilation with tidal volumes below 8 ml/kg remains modest [2,3].
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