Lung-protective ventilation is a ventilation strategy that is often associated with Acute Respiratory Distress Syndrome (ARDS) but is now widely used even in non-ARDS patients. It comes out of the ARDSNet trial, which compared outcomes using high tidal volumes (12 mL/kg) with lower tidal volumes (6 mL/kg of ideal body weight), finding that ventilation at the lower tidal volume resulted in average lower in-hospital mortality and duration of ventilation. It is believed that these lower tidal volumes produce less barotrauma (such as alveolar rupture), leading to improved outcomes.

The ARDSnet trial produced a ventilatory strategy used in ARDS patients: low tidal volumes (6 mL/kg), low plateau pressures (30 mL/kg) allowing for some degree of hypercapnia. It also recommended that PEEP and FiO2 be adjusted in a stepwise fashion, to a goal SpO2 of 88-95%. A simplified version of this recommendation is listed in the table below.