Evaluation of a ventilation strategy to prevent barotrauma in patients at high risk for acute respiratory distress syndrome. Pressure- and Volume-Limited Ventilation Strategy Group

The New England Journal of Medicine
T E StewartA S Slutsky

Abstract

A strategy of mechanical ventilation that limits airway pressure and tidal volume while permitting hypercapnia has been recommended for patients with the acute respiratory distress syndrome. The goal is to reduce lung injury due to overdistention. However, the efficacy of this approach has not been established. Within 24 hours of intubation, patients at high risk for the acute respiratory distress syndrome were randomly assigned to either pressure- and volume-limited ventilation (limited-ventilation group), with the peak inspiratory pressure maintained at 30 cm of water or less and the tidal volume at 8 ml per kilogram of body weight or less, or to conventional ventilation (control group), with the peak inspiratory pressure allowed to rise as high as 50 cm of water and the tidal volume at 10 to 15 ml per kilogram. All other ventilatory variables were similar in the two groups. A total of 120 patients with similar clinical features underwent randomization (60 in each group). The patients in the limited-ventilation and control groups were exposed to different mean (+/-SD) tidal volumes (7.2+/-0.8 vs. 10.8+/-1.0 ml per kilogram, respectively; P<0.001) and peak inspiratory pressures (23.6+/-5.8 vs. 34.0+/-11.0 cm of water, P<0.001)...Continue Reading

References

Nov 16, 1979·JAMA : the Journal of the American Medical Association·W M ZapolR G Miller
Jan 1, 1990·Intensive Care Medicine·K G Hickling
Feb 1, 1990·Chest·P C LeeM P Fink
Jul 1, 1986·Journal of Thoracic Imaging·L GattinoniG Cappelletti
Feb 1, 1987·Pediatric Clinics of North America·R M OrtizR H Bartlett
Oct 1, 1985·Critical Care Medicine·W A KnausJ E Zimmerman
Mar 1, 1967·The American Journal of Physiology·T J Bersentes, D H Simmons
Dec 1, 1981·Archives of Internal Medicine·T LindL V Avioli
Oct 1, 1995·Critical Care Medicine·J C MarshallW J Sibbald
Jul 1, 1995·American Journal of Respiratory and Critical Care Medicine·E RoupieL Brochard
Jan 25, 1995·JAMA : the Journal of the American Medical Association·J A MilbergL D Hudson
Dec 1, 1994·American Journal of Respiratory and Critical Care Medicine·F Feihl, C Perret
Sep 1, 1994·American Journal of Respiratory and Critical Care Medicine·D V Tuxen
May 1, 1994·American Journal of Respiratory and Critical Care Medicine·J G MuscedereA S Slutsky
Mar 1, 1993·Journal of Pediatric Surgery·R E CilleyA G Coran

❮ Previous
Next ❯

Citations

Sep 4, 2004·Indian Journal of Pediatrics·Anil VasudevanS K Kabra
Aug 29, 2006·Indian Journal of Pediatrics·Ajay R Desai, Akash Deep
May 23, 1998·Canadian Journal of Anaesthesia = Journal Canadien D'anesthésie·G Blaise, E Troncy
Oct 19, 2005·Intensive Care Medicine·Lorraine N Tremblay, Arthur S Slutsky
Dec 7, 2007·Intensive Care Medicine·R Phillip DellingerJean-Louis Vincent
Jan 10, 2008·Intensive Care Medicine·Gustavo A Ospina-TascónJean-Louis Vincent
Apr 23, 2008·Intensive Care Medicine·Rafael FernandezMaria Jesus Lopez
Jun 18, 2009·Intensive Care Medicine·Robinder G KhemaniChristopher J L Newth
Sep 18, 2009·Intensive Care Medicine·Laurent J Brochard
Sep 24, 2010·Intensive Care Medicine·Aissam LyazidiJean-Christophe M Richard
Sep 28, 2010·Intensive Care Medicine·Lise PiquilloudDidier Tassaux
Oct 31, 2012·Intensive Care Medicine·Francois Lellouche, Jed Lipes
Jan 31, 2013·Intensive Care Medicine·R P DellingerUNKNOWN Surviving Sepsis Campaign Guidelines Committee including The Pediatric Subgroup
Apr 16, 1998·Intensive Care Medicine·D Dreyfuss, G Saumon
Aug 19, 2005·Current Infectious Disease Reports·Dean R Hess, B Taylor Thompson
Aug 25, 2009·Current Infectious Disease Reports·Davide Chiumello, Massimo Cressoni
Jan 5, 2002·Comprehensive Therapy·A M Karnik
Jul 10, 2009·Annales Françaises D'anesthèsie Et De Rèanimation·P C Rimensberger
Feb 24, 2001·The Annals of Thoracic Surgery·J B ZwischenbergerA Bidani
Feb 1, 2003·Lancet·Liao PinhuMark Griffiths
May 10, 2001·Archives of Medical Research·G F de Anda, B Lachmann
Oct 6, 2000·Clinics in Chest Medicine·R G Brower, H E Fessler
Apr 18, 2000·Critical Care Clinics·A M Fein, M G Calalang-Colucci
Jul 19, 2002·Chest Surgery Clinics of North America·Steven A Conrad, Akhil Bidani
Oct 18, 2003·Cytokine & Growth Factor Reviews·Richard B GoodmanMichael A Matthay
Dec 16, 1998·Anaesthesia·M Sair, T W Evans
Feb 5, 1998·The New England Journal of Medicine·L D Hudson
Jul 21, 1998·The New England Journal of Medicine·J D ChicheR Kacmarek
Feb 17, 2000·The New England Journal of Medicine·R D TruogW Robinson
May 4, 2000·The New England Journal of Medicine·UNKNOWN Acute Respiratory Distress Syndrome NetworkArthur Wheeler
May 4, 2000·The New England Journal of Medicine·L B Ware, M A Matthay
May 4, 2000·The New England Journal of Medicine·M J Tobin
Sep 19, 2000·The New England Journal of Medicine·J G Laffey, B P Kavanagh
Jun 30, 2001·The New England Journal of Medicine·M J Tobin
Sep 13, 2002·The New England Journal of Medicine·François FeihlSerge Brimioulle
Sep 15, 2007·The New England Journal of Medicine·Atul Malhotra
Dec 25, 2010·European Journal of Public Health·C C H WieldersM A B van der Sande
Jul 22, 1998·Critical Care Medicine·J W Hoyt

❮ Previous
Next ❯

Related Concepts

Trending Feeds

COVID-19

Coronaviruses encompass a large family of viruses that cause the common cold as well as more serious diseases, such as the ongoing outbreak of coronavirus disease 2019 (COVID-19; formally known as 2019-nCoV). Coronaviruses can spread from animals to humans; symptoms include fever, cough, shortness of breath, and breathing difficulties; in more severe cases, infection can lead to death. This feed covers recent research on COVID-19.

Blastomycosis

Blastomycosis fungal infections spread through inhaling Blastomyces dermatitidis spores. Discover the latest research on blastomycosis fungal infections here.

Nuclear Pore Complex in ALS/FTD

Alterations in nucleocytoplasmic transport, controlled by the nuclear pore complex, may be involved in the pathomechanism underlying multiple neurodegenerative diseases including Amyotrophic Lateral Sclerosis and Frontotemporal Dementia. Here is the latest research on the nuclear pore complex in ALS and FTD.

Applications of Molecular Barcoding

The concept of molecular barcoding is that each original DNA or RNA molecule is attached to a unique sequence barcode. Sequence reads having different barcodes represent different original molecules, while sequence reads having the same barcode are results of PCR duplication from one original molecule. Discover the latest research on molecular barcoding here.

Chronic Fatigue Syndrome

Chronic fatigue syndrome is a disease characterized by unexplained disabling fatigue; the pathology of which is incompletely understood. Discover the latest research on chronic fatigue syndrome here.

Evolution of Pluripotency

Pluripotency refers to the ability of a cell to develop into three primary germ cell layers of the embryo. This feed focuses on the mechanisms that underlie the evolution of pluripotency. Here is the latest research.

Position Effect Variegation

Position Effect Variagation occurs when a gene is inactivated due to its positioning near heterochromatic regions within a chromosome. Discover the latest research on Position Effect Variagation here.

STING Receptor Agonists

Stimulator of IFN genes (STING) are a group of transmembrane proteins that are involved in the induction of type I interferon that is important in the innate immune response. The stimulation of STING has been an active area of research in the treatment of cancer and infectious diseases. Here is the latest research on STING receptor agonists.

Microbicide

Microbicides are products that can be applied to vaginal or rectal mucosal surfaces with the goal of preventing, or at least significantly reducing, the transmission of sexually transmitted infections. Here is the latest research on microbicides.