Evaluation of a Ventilation Strategy to Prevent Barotrauma in Patients at High Risk for Acute Respiratory Distress Syndrome

Autor:	Deborah J. Cook, R. F. Mclean, C. D. Mazer, B. D. Schouten, John Granton, Stephen E. Lapinsky, Thomas E. Stewart, R. V. Hodder, T. S. Rogovein, T. R. J. Todd, Maureen O. Meade, Arthur S. Slutsky
Rok vydání:	1998
Předmět:	Mechanical ventilation Respiratory distress business.industry medicine.medical_treatment Respiratory disease General Medicine Peak inspiratory pressure Lung injury medicine.disease Anesthesia medicine Breathing medicine.symptom business Hypercapnia Tidal volume
Zdroj:	New England Journal of Medicine. 338:355-361
ISSN:	1533-4406 0028-4793
DOI:	10.1056/nejm199802053380603
Popis:	Background 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. Methods 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. Results A total of 120 patients with similar clinical features underwent randomization (60 in each group). The ...
Databáze:	OpenAIRE
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