The Search for the Optimal Tidal Volume: Why Do We Use Body Weight?

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The tidal volumes used during mechanical ventilation can be a contributing factor to lung injury in the perioperative period.1 Tidal volumes are only one of multiple factors that have been shown to interact in a complex fashion to potentially injure a patient’s lungs.2 Among these other potential factors are driving pressure,3 positive end expiratory pressure (PEEP)4 recruitment,5 FIO2, inflammation, anti-inflammatories (including some anesthetics),6 blood products, and other fluids.7 However, among the multiple factors that enter in the equation of lung injury, tidal volumes are the most studied factor, both in healthy and in previously injured lungs. The reasons that tidal volumes have been scrutinized so closely are not completely obvious. It could be due to the availability of data for retrospective studies or due to the ability to control this variable in prospective studies.
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