Ventilator associated or induced lung injury. Does the name matter? Point and counterpoint

Abstract

The terminology used to describe lung injuries in patients receiving mechanical ventilation has significant implications for clinical practice, research, and communication among healthcare professionals. This point-counterpoint discussion paper explores the debate over the appropriate term to use: "ventilator-associated lung injury" (VALI) or "ventilator-induced lung injury" (VILI). The first author argues in favor of the term "ventilator-associated lung injury” from epistemology, philosophy, epidemiology and statistics, seems to correctly substantiate the relationship between lung injury as a consequence of inadequate mechanical ventilator programming. According to this perspective, "associated" more accurately reflects the complex interplay of these elements, which together contribute to the development of lung injury in ventilated patients. The second author advocates for the term "ventilator-induced lung injury," underscoring the direct causative role of mechanical ventilation in the development of lung injuries. This perspective highlights the specific pathological changes that result directly from mechanical ventilation strategies. According to this prospective "induced" is considered a more precise term, attributing the injury directly to the intervention of mechanical ventilation. Through this exchange, the authors provide a comprehensive analysis of the clinical and scientific implications of each term, ultimately seeking to guide consensus in the field regarding the most accurate and useful terminology. Keywords: VALI, VILI