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lüll Is acute respiratory distress syndrome an iatrogenic disease?Villar J; Slutsky ASCrit Care 2010[]; 14 (1): 120In this month's issue of Critical Care, Determann and colleagues report the results of a randomized controlled trial comparing the effects of mechanical ventilation (MV) with two tidal volumes (6 versus 10 ml/kg predicted body weight) on cytokine levels in lung lavage fluid and plasma as a surrogate for early identification of acute lung injury (ALI) and/or acute respiratory distress syndrome (ARDS). The study was stopped early after an interim analysis - when 150 patients were enrolled - showing that the incidence of ALI/ARDS according to the current definition was 10.9% higher in the 10 ml/kg group, although duration of MV and mortality was similar in both groups. We examine these interesting results after providing a brief historical perspective and discuss the limitations and implications of the study.|*Iatrogenic Disease[MESH]|Bronchoalveolar Lavage Fluid[MESH]|Cytokines/blood/metabolism[MESH]|Humans[MESH]|Respiration, Artificial/adverse effects[MESH]|Respiratory Distress Syndrome/*etiology/metabolism[MESH] |