Recent published reports have arrived at conflicting conclusions regar
ding the potential adverse effects of high-inflation pressure on venti
lator-induced lung injury. The contribution of positive end-expiratory
pressure to high airway pressure-induced lung injury is even more con
troversial. Oxygen toxicity, macrobarotrauma, and volutrauma interact
to produce ventilator-induced lung injury. This article explores the m
any manifestations of ventilator-induced lung injury and the means pro
posed to prevent or limit its physiologic effects.