Abstract
The importance of limiting tidal volume to a normal physiologic value has been long recognized as an important factor in minimizing lung injury due to excessive tissue stretching, known as volutrauma.1,2 Equally important is achieving homogeneous lung inflation to ensure even distribution of the tidal volume throughout the lungs.3 Failure to achieve adequate lung volume recruitment results in ventilator associated lung injury through several mechanisms, including shear forces at the boundary between aerated and unaerated lung, inactivation of surfactant in the atelectatic portions of the lungs and, perhaps most importantly, overexpansion of the aerated portion of the lung with each inflation.
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