The present study shows that protective non-injurious ventilation requires the application of frequent non-injurious recruitment manoeuvres and low V T . A ventilation pattern including deep inflations is closer to the variable breathing pattern of spontaneously breathing subjects than monotonic MV without variation in V T or breathing frequency, supporting the finding that variable or 'noisy' ventilation improves protective ventilation in the porcine and human lung [57, 58] . Beyond that, variable ventilation, characterised by breath-to-breath variation of V T and breathing frequency, has been shown to be beneficial in terms of reducing VILI in mice with injured lungs [59] .