![]() Measurements were repeatedĢ4 to 30 and 36 to 40 hours after randomization.Main Outcome MeasuresPulmonary and systemic concentrations of inflammatory mediators approximatelyģ6 hours after randomization.ResultsPhysiological characteristics and cytokine concentrations were similar Volume and PEEP based on the volume-pressure curve. Worsening hemodynamics or the lung-protective strategy group (n=18): tidal (PEEP) producing the greatest improvement in arterial oxygen saturation without The control group (n=19): tidal volume to obtain normal values of arterialĬarbon dioxide tension (35-40 mm Hg) and positive end-expiratory pressure Hospitals from November 1995 to February 1998, with a 28-day follow-up.PatientsForty-four patients (mean age, 50 years) with acute respiratoryĭistress syndrome were enrolled, 7 of whom were withdrawn due to adverse events.InterventionsAfter admission, volume-pressure curves were measured and bronchoalveolar Or derecruitment and overdistention.Design and SettingRandomized controlled trial in the intensive care units of 2 European ![]() Strategy may reduce this response.ObjectiveTo test the hypothesis that mechanical ventilation induces a pulmonaryĪnd systemic cytokine response that can be minimized by limiting recruitment Lung units or to overdistend alveolar regions, and that a lung-protective Mechanical ventilation used for recruitment or derecruitment of collapsed The mean tidal volumes on days 1 to 3 were 6.2+/-0.8 and 11.8+/-0.8 ml per kilogram of predicted body weight (P Conclusions In patients with acute lung injury and the acute respiratory distress syndrome, mechanical ventilation with a lower tidal volume than is traditionally used results in decreased mortality and increases the number of days without ventilator use.read more read lessĪbstract: ContextStudies have shown that an inflammatory response may be elicited by 39.8 percent, P=0.007), and the number of days without ventilator use during the first 28 days after randomization was greater in this group (mean, 12+/-11 vs. Results The trial was stopped after the enrollment of 861 patients because mortality was lower in the group treated with lower tidal volumes than in the group treated with traditional tidal volumes (31.0 percent vs. ![]() ![]() The primary outcomes were death before a patient was discharged home and was breathing without assistance and the number of days without ventilator use from day 1 to day 28. The trial compared traditional ventilation treatment, which involved an initial tidal volume of 12 ml per kilogram of predicted body weight and an airway pressure measured after a 0.5-second pause at the end of inspiration (plateau pressure) of 50 cm of water or less, with ventilation with a lower tidal volume, which involved an initial tidal volume of 6 ml per kilogram of predicted body weight and a plateau pressure of 30 cm of water or less. Methods Patients with acute lung injury and the acute respiratory distress syndrome were enrolled in a multicenter, randomized trial. We therefore conducted a trial to determine whether ventilation with lower tidal volumes would improve the clinical outcomes in these patients. Abstract: Background Traditional approaches to mechanical ventilation use tidal volumes of 10 to 15 ml per kilogram of body weight and may cause stretch-induced lung injury in patients with acute lung injury and the acute respiratory distress syndrome. ![]()
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