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Lung-protective mechanical ventilation with lower tidal volumes in patients not suffering from acute lung injury: a review of clinical studies.
Med Sci Monit. 2008 Feb; 14(2):RA22-26.MS

Abstract

Two randomized controlled trials confirmed the existence of so-called ventilator-associated lung injury by showing reduced morbidity and mortality with the use of lower tidal volumes in patients with acute lung injury (ALI) or its more severe form, acute respiratory distress syndrome (ARDS). While guidelines now strongly advise using lower tidal volumes in ALI/ARDS patients, at present there are no widely agreed upon guidelines for setting tidal volumes in patients who do not suffer from ALI/ARDS. The literature was searched for clinical studies on lung-protective mechanical ventilation using lower tidal volumes in patients not suffering from ALI/ARDS. The best available evidence comes from large retrospective or observational studies which suggest a causal relation between the use of large tidal volumes and the development of lung injury. The inconsistent results from smaller randomized controlled trials, however, do not definitely support the use of lower tidal volumes. The association with potentially injurious ventilator settings, in particular large tidal volumes, suggests that additional lung injury in mechanically ventilated patients without ALI/ARDS is, in part, a preventable complication. Nevertheless, more prospective studies are needed to evaluate optimal ventilator management strategies for patients not suffering from ALI/ARDS.

Authors+Show Affiliations

Department of Intensive Care Medicine, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands. m.j.schultz@amc.uva.nl

Pub Type(s)

Journal Article
Review

Language

eng

PubMed ID

18227773

Citation

Schultz, Marcus J.. "Lung-protective Mechanical Ventilation With Lower Tidal Volumes in Patients Not Suffering From Acute Lung Injury: a Review of Clinical Studies." Medical Science Monitor : International Medical Journal of Experimental and Clinical Research, vol. 14, no. 2, 2008, pp. RA22-26.
Schultz MJ. Lung-protective mechanical ventilation with lower tidal volumes in patients not suffering from acute lung injury: a review of clinical studies. Med Sci Monit. 2008;14(2):RA22-26.
Schultz, M. J. (2008). Lung-protective mechanical ventilation with lower tidal volumes in patients not suffering from acute lung injury: a review of clinical studies. Medical Science Monitor : International Medical Journal of Experimental and Clinical Research, 14(2), RA22-26.
Schultz MJ. Lung-protective Mechanical Ventilation With Lower Tidal Volumes in Patients Not Suffering From Acute Lung Injury: a Review of Clinical Studies. Med Sci Monit. 2008;14(2):RA22-26. PubMed PMID: 18227773.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Lung-protective mechanical ventilation with lower tidal volumes in patients not suffering from acute lung injury: a review of clinical studies. A1 - Schultz,Marcus J, PY - 2008/1/30/pubmed PY - 2008/5/3/medline PY - 2008/1/30/entrez SP - RA22 EP - 26 JF - Medical science monitor : international medical journal of experimental and clinical research JO - Med Sci Monit VL - 14 IS - 2 N2 - Two randomized controlled trials confirmed the existence of so-called ventilator-associated lung injury by showing reduced morbidity and mortality with the use of lower tidal volumes in patients with acute lung injury (ALI) or its more severe form, acute respiratory distress syndrome (ARDS). While guidelines now strongly advise using lower tidal volumes in ALI/ARDS patients, at present there are no widely agreed upon guidelines for setting tidal volumes in patients who do not suffer from ALI/ARDS. The literature was searched for clinical studies on lung-protective mechanical ventilation using lower tidal volumes in patients not suffering from ALI/ARDS. The best available evidence comes from large retrospective or observational studies which suggest a causal relation between the use of large tidal volumes and the development of lung injury. The inconsistent results from smaller randomized controlled trials, however, do not definitely support the use of lower tidal volumes. The association with potentially injurious ventilator settings, in particular large tidal volumes, suggests that additional lung injury in mechanically ventilated patients without ALI/ARDS is, in part, a preventable complication. Nevertheless, more prospective studies are needed to evaluate optimal ventilator management strategies for patients not suffering from ALI/ARDS. SN - 1234-1010 UR - https://www.unboundmedicine.com/medline/citation/18227773/Lung_protective_mechanical_ventilation_with_lower_tidal_volumes_in_patients_not_suffering_from_acute_lung_injury:_a_review_of_clinical_studies_ L2 - https://www.medscimonit.com/download/index/idArt/734746 DB - PRIME DP - Unbound Medicine ER -