It is striking that, as has been described in similar studies on mechanical ventilation performed during the 2009 influenza A (H1N1) pandemic [6, 7] , tidal volumes used were between 7.5 and 8.3 ml/kg IBW, certainly higher than the 6 ml/kg demonstrated as being lungprotective [27] . Indeed, barriers to implementing lowtidal volume have been identified and might explain physician behavior [28] . Despite this, plateau pressures did remain below 30 cmH 2 O [29] , indicating that lung compliance might have been preserved. Perhaps clinicians focused on plateau pressures rather than on tidal volumes [30] since it still remains unclear which should be limited to avoid ventilator-induced lung injury [31] . We, like others [6, 7, 32, 33] , could not find differences in utilized tidal volumes between survivors and non-survivors. Even so, non-survivors tended to display lower values, probably reflecting physician efforts to intensify protective ventilation strategies in the most severely compromised. Some researchers [34, 35] have suggested that allowing higher tidal volumes in a population of young and previously healthy patients with strong ventilatory drive might reveal an attempt to restrain heavy sedation and neuromuscular blocker use. Notwithstanding this, we believe that these findings may also represent clinicians' inadequate prescription, as described in other scenarios [36] .