Programmed Multi-Level Ventilation: A Strategy for Ventilating Non-Homogenous Lungs

Mechanical ventilation (MV) has been an integral method used in ICU care for decades. MV is typically viewed as a life-supporting intervention. However, it can also contribute to lung injury through stress and strain, as evidenced by ventilator-induced lung injury (VILI), even in previously healthy lungs. The negative impact may be worsened when significant lung non-homogeneity is present, eg. ALI and ARDS. Protective lung strategies to minimize VILI are to use low tidal volumes (Vt 4-6 mL/kg/PBW), plateau pressures ([P.sub.plat])