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Abstract Mechanical ventilation is indispensable in support of patients with respiratory failure who are critically ill. However, use of this technique has adverse effects; one of these is ventilator-associated lung injury (VALI). There are clear data showing the clinical impact of VALI. The magnitude of the clinical burden of VALI was shown by ARDS net trial; at least 8.8% of the absolute mortality from ARDS is attributable to VALI. A large number of randomized controlled clinical trials have now been conducted evaluating the efficacy and safety of various methods of mechanical ventilation. Low tidal volume ventilation should be utilized to improve survival. Variable positive end-expiratory pressure (PEEP) with different FiO2 ratio and alveolar recruitment maneuvers may be useful as rescue therapy in a patient with VALI. Prospective studies are still wanted to further evaluate the optimal ventilator management strategies for patients in need of mechanical ventilation. |