Efficacy of Low Tidal Volume Ventilation in Patients with Different Clinical Risk Factors for Acute Lung Injury and the Acute Respiratory Distress Syndrome

Adult Male Respiratory Distress Syndrome Multiple Organ Failure Middle Aged Respiration, Artificial 3. Good health 03 medical and health sciences 0302 clinical medicine Risk Factors Multivariate Analysis Tidal Volume Humans Female Ventilator Weaning
DOI: 10.1164/ajrccm.164.2.2011093 Publication Date: 2013-04-04T18:45:45Z
ABSTRACT
In patients with acute lung injury (ALI) and respiratory distress syndrome (ARDS), a recent ARDS Network randomized controlled trial demonstrated that low tidal volume (Vt) mechanical ventilation strategy (6 ml/kg) reduced mortality by 22% compared traditional (12 ml/kg). this study, we examined the relative efficacy of Vt among 902 different clinical risk factors for ALI/ARDS who participated in trials. The factor was associated substantial variation mortality. death (before discharge home unassisted breathing) highest sepsis (43%); intermediate subjects pneumonia (36%), aspiration (37%), other (35%); lowest those trauma (11%) (p < 0.0001). Despite these differences mortality, there no evidence varied = 0.76, interaction between ventilator group factor). There also differential study outcomes: proportion achieving breathing 0.59), ventilator-free days 0.58), or development nonpulmonary organ failure 0.44). Controlling demographic covariates did not appreciably affect results. After reclassifying as pulmonary versus predisposing conditions infection-related non-infection-related conditions, still differed subgroups. conclusion, found subgroups ALI/ARDS.Keywords: syndrome; ventilators;
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