It was not until 1974 that Webb and Tierney described this phenomenon, called volutrauma when they demonstrated pulmonary edema in rats after exposure to high inflation pressures.
The result is the initiation of an inflammatory cascade characterized by increased lung permeability, pulmonary edema, alteration of surfactant, and production of cytokines that injure the lungs. However, ventilation with large tidal volumes causes volutrauma due to alveolar overdistension and repetitive opening of collapsed alveoli. The rationale was to reduce hypoxemia, prevent airway closure, and increase functional residual capacity. Initially, mechanical ventilation involved delivering tidal volumes of 10 mL/kg of ideal body weight or higher.
The goal is to deliver a tidal volume large enough to maintain adequate ventilation but small enough to prevent lung trauma. Tidal volume is vital when it comes to setting the ventilator in critically ill patients.
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