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Toward a better ventilation strategy for patients with acute lung injury
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 vol...
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Formato: | Texto |
Lenguaje: | English |
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BioMed Central
2000
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Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC150037/ https://www.ncbi.nlm.nih.gov/pubmed/11094502 http://dx.doi.org/10.1186/cc695 |
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author | Pinsky, Michael R |
author_facet | Pinsky, Michael R |
author_sort | Pinsky, Michael R |
collection | PubMed |
description | 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. |
format | Text |
id | pubmed-150037 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2000 |
publisher | BioMed Central |
record_format | MEDLINE/PubMed |
spelling | pubmed-1500372003-02-27 Toward a better ventilation strategy for patients with acute lung injury Pinsky, Michael R Crit Care Commentary 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. BioMed Central 2000 2000-07-03 /pmc/articles/PMC150037/ /pubmed/11094502 http://dx.doi.org/10.1186/cc695 Text en Copyright © 2000 Current Science Ltd |
spellingShingle | Commentary Pinsky, Michael R Toward a better ventilation strategy for patients with acute lung injury |
title | Toward a better ventilation strategy for patients with acute lung injury |
title_full | Toward a better ventilation strategy for patients with acute lung injury |
title_fullStr | Toward a better ventilation strategy for patients with acute lung injury |
title_full_unstemmed | Toward a better ventilation strategy for patients with acute lung injury |
title_short | Toward a better ventilation strategy for patients with acute lung injury |
title_sort | toward a better ventilation strategy for patients with acute lung injury |
topic | Commentary |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC150037/ https://www.ncbi.nlm.nih.gov/pubmed/11094502 http://dx.doi.org/10.1186/cc695 |
work_keys_str_mv | AT pinskymichaelr towardabetterventilationstrategyforpatientswithacutelunginjury |