Lessons From Gattinoni

Abstract

Professor Luciano Gattinoni’s contributions to critical care medicine transformed the management of ARDS and mechanical ventilation, shaping the foundation of modern intensive care. Among his landmark achievements, the so-called baby lung concept redefined ARDS as a condition characterized by reduced functional lung volume, rather than lung stiffness, leading to the development of lung-protective ventilation strategies that prioritize minimizing ventilator-induced lung injury. His work on positive end-expiratory pressure advanced the understanding of lung aeration, atelectasis, and recruitment, highlighting the role of CT imaging in respiratory research. His research on prone positioning elucidated its physiologic benefits and demonstrated its lifesaving potential for patients with severe ARDS, culminating in its widespread adoption. Additionally, his work on mechanical power provided a unifying framework for assessing ventilator-induced lung injury risk, although challenges in its bedside application remain. Through his relentless pursuit of integrating respiratory physiology into clinical practice, Professor Gattinoni inspired generations of clinicians and researchers, leaving an indelible legacy that continues to guide advancements in critical care worldwide.