NORMAL TIDAL VOLUME IN ML VERIFICATION

Some physicians are skeptical about applying evidence derived from randomized control trials to critical care practice, 9,10 some may concern complications of low V T such as hypercapnia, 11 air hunger sensation 12 and possible self-inflicted lung injury if there is no adequate sedation or paralysis. 8 The reasons for nonadherence to low V T ventilation are complex. 6,7 A survey of Chicago physicians found that more than 92% knew that patients with ARDS warranted low V T ventilation, but they ordered low V T in only 7% (0–14%) of their eligible patients. Two decades after the publication of the landmark study, 1 low V T adherence remains poor throughout the world.

5 Therefore, we hypothesize that intermediate V T (7.5–10 ml/kg PBW), by shunning the deleterious effects of high V T, could also be lung-protective as low V T. 2–4 With V T around 10 ml/kg PBW and plateau pressure less than 31 cmH 2O in the control groups, the beneficial effects of low V T were completely abolished in these 3 studies. This speculation was supported by 3 futile clinical trials in low V T before the year 2000. 1 The superiority of low V T in this study may stem more from avoiding the harmful effects of high V T (12 ml/kg PBW) and plateau pressure (up to 50 cmH 2O) than strict adherence to low V T per se. A well-known study by the ARDS Network in 2000 demonstrated that low V T (6 ml/kg predicted body weight, PBW) is better than high V T (12 ml/kg PBW) in terms of mortality and ventilator-free days. Many harmful effects of mechanical ventilation, such as ventilator-induced lung injury (VILI), have been recognized and led to the development of a lung-protective ventilatory strategy, mainly by keeping tidal volume ( V T) low. Mechanical ventilator support remains the cornerstone of acute respiratory distress syndrome (ARDS) management. Esta conclusión necesita verificación a través de ensayos clínicos. La V T intermedia, con resultados similares a la V T pequeña, es una opción aceptable para pacientes con ARDS ventilados. Cuando los grupos de V T intermedia y baja se emparejaron en puntajes de propensión (n = 66 para cada grupo), sus resultados tampoco fueron significativamente diferentes. El análisis multivariado reveló que la V T alta se asoció de forma independiente con la mortalidad 28-D y 90-D, pero la V T intermedia no se asoció significativamente con la mortalidad 28-D (HR 1,34, IC 0,92-1,97, p = 0,13) o la mortalidad 90-D. 63%, p = 0,06) u otros resultados como mortalidad 90-D, días sin ventilador, dependencia del ventilador índice. Con un ARDS inicial similar y una gravedad en la UCI, los grupos de V T intermedia y baja no difirieron en la mortalidad 28-D (47% vs. Un total de 382 pacientes, con 6958 configuraciones de ventilador elegibles para protección pulmonar, se clasificaron en bajo (V T medio = 6,7 ml/kg), intermedio (V T medio = 8,9 ml/kg) y alto (V T medio = 11,2 ml/kg). Pacientes con ARDS bajo ventilación invasiva. ÁmbitoĬinco UCI con un total de 130 camas en Taiwán. No se ha estudiado la eficacia de la V T intermedia en el ARDS y es el objetivo de este estudio. La V T intermedia es un escenario común para los pacientes con ARDS y se ha demostrado que es tan eficaz como la V T baja en pacientes sin ARDS. La evidencia solo demuestra que el volumen tidal (V T) bajo supera al alto para el síndrome de dificultad respiratoria aguda (ARDS).

NORMAL TIDAL VOLUME IN ML VERIFICATION

This conclusion needs verification through clinical trials.

Intermediate V T, with its outcomes similar to small V T, is an acceptable option for ventilated ARDS patients.

When the intermediate and low V T groups were matched in propensity scores ( n = 66 for each group), their outcomes were also not significantly different. Multivariate analysis revealed high V T was independently associated with 28-D and 90-D mortality, but intermediate V T was not significantly associated with 28-D mortality (HR 1.34, CI 0.92–1.97, P = 0.13) or 90-D mortality. 63%, P = 0.06) or other outcomes such as 90-D mortality, ventilator-free days, ventilator-dependence rate. With similar baseline ARDS and ICU severities, intermediate and low V T groups did not differ in 28-D mortality (47% vs. Totally 382 patients, with 6958 ventilator settings eligible for lung protection, were classified into low (mean V T = 6.7 ml/kg), intermediate (mean V T = 8.9 ml/kg) and high (mean V T = 11.2 ml/kg) V T groups. Patients or participantsĪRDS patients under invasive ventilation. Designįive ICUs with their totally 130 beds in Taiwan. The effectiveness of intermediate V T in ARDS has not been studied and is the objective of this study. Intermediate V T is a common setting for ARDS patients and has been demonstrated as effective as low V T in non-ARDS patients.

Evidence only proves low surpasses high tidal volume ( V T) for acute respiratory distress syndrome (ARDS).

Normal tidal volume in ml