Much of the research in relation to the treatment of ARDS has been designed to define protective ventilation strategies based on the use of low tidal volumes, which have been shown to improve patient survival. This results in very heterogeneous alveolar filling. In this way, in the dependent pulmonary zones, with the patient in supine decubitus at dorsal level, aeration is poorer than in the non-dependent zones at sternal level. Some lung regions are relatively well aerated and participate in gas exchange, while others are collapsed as a result of the inflammatory contents within the alveoli or because of the increase in interstitial pressure and the weight of the lung tissue. The babylung concept refers to the great lung parenchyma heterogeneity that characterizes ARDS. 1,2 It has been estimated that patients with ARDS represent up to 10–15% of all patients admitted to the Intensive Care Unit (ICU), and 20% of those who require mechanical ventilation during more than 24 h. Acute respiratory distress syndrome (ARDS) remains an important cause of severe respiratory failure, with a mortality rate of up to 30–60% according to different studies.
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