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Objectives:

To describe the changes that have occurred in mechanical ventilation in children with acute lung injury in our institution over the last 10–15 yrs and to examine the impact of these changes, in particular of the delivered tidal volume on mortality.

Design:

Retrospective study.

Setting:

University-affiliated children's hospital.

Patients:

The management of mechanical ventilation between 1988 and 1992 (past group, n= 79) was compared with the management between 2000 and 2004 (recent group, n= 85).

Interventions:

None.

Measurements and Main Results:

The past group patients were ventilated with a significantly higher mean tidal volume (10.2±1.7 vs. 8.1±1.4 mL· kg− 1 actual body weight, p<. 001), lower levels of positive end-expiratory pressure (6.1±2.7 vs. 7.1±2.4 cm H 2 O, p=. 007), and higher mean peak inspiratory pressure (31.5±7.3 vs. 27.8±4.2 cm H 2 O, p<. 001) than the recent group patients. The …