Toward a better ventilation strategy for patients with acute lung injury
AUTOR(ES)
Pinsky, Michael R
FONTE
BioMed Central
RESUMO
Ventilator-induced lung injury is a major outcome determinant of the acute respiratory distress syndrome (ARDS). Ventilatory strategies that limit ventilator-induced lung injury should improve outcome from ARDS. The ARDSnet trial showed improved survival in subjects ventilated with a lower tidal volume. Although this trial developed and tested a rigorous clinical protocol, it did not define the limits to which tidal volume reduction would benefit outcome. It is also not at all clear if it is the reduction in tidal volume or the reduction in plateau airway pressure that confers this benefit. Finally, ventilator-induced lung injury occurs more commonly from repetitive collapse and re-expansion of injured lung units rather than from the overdistention of persistently aerated lung units. This was not addressed in the trial design. Thus, further study using targeted open-lung strategies are also needed.
ACESSO AO ARTIGO
http://www.pubmedcentral.nih.gov/articlerender.fcgi?artid=150037Documentos Relacionados
- Cost-effectiveness of Implementing Low-Tidal Volume Ventilation in Patients With Acute Lung Injury
- Airway pressure release ventilation increases cardiac performance in patients with acute lung injury/adult respiratory distress syndrome
- Ventilation with high tidal volume induces inflammatory lung injury
- Quantitation of nitrotyrosine levels in lung sections of patients and animals with acute lung injury.
- A comparison of biologically variable ventilation to recruitment manoeuvres in a porcine model of acute lung injury