Mechanical ventilation with a lower tidal volume resulted in decreased mortality in patients with acute lung injury and the acute respiratory distress syndrome
QUESTION: In patients with acute lung injury or the acute respiratory distress syndrome (ARDS), does mechanical ventilation with lower tidal volumes improve clinical outcomes?
Design
Randomised (allocation concealed), unblinded, controlled trial with 28 days of follow up. The trial was stopped after 861 patients were enrolled.
Setting
10 university centres in the US.
Patients
861 intubated patients (mean age 51 y, 60% men) receiving mechanical ventilation who had an acute decrease in the ratio of partial pressure of arterial oxygen to fraction of inspired oxygen (PaO2:FiO2 ratio) to ≤300 (indicating onset of hypoxemia), bilateral pulmonary infiltrates on a chest radiograph consistent with oedema, and no evidence of left atrial hypertension for <36 hours. Exclusion criteria included <18 years of age, increased intracranial pressure, neuromuscular disease that could impair spontaneous breathing, sickle …
