Lung salvage and protection ventilatory techniques.

Physicians are in the beginning of an era in intensive care medicine in which they finally are starting to see improved outcomes in patients with AHRF. At the same time, intensivists are presented with a bewildering choice of ventilator options and adjunctive therapies. Trying to sort out which are "cosmetic," that is, improve the blood gases as opposed to influencing the outcome, remains a challenge and will be resolved only with additional RCTs. Principles of ventilator management that are driven by mimicking normal physiology are inappropriate and must be rethought.