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Mechanical ventilation with a lower tidal volume resulted in decreased mortality in patients with acute lung injury and the acute respiratory distress syndrome

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QUESTION: In patients with acute lung injury or the acute respiratory distress syndrome (ARDS), does mechanical ventilation with lower tidal volumes improve clinical outcomes?


Randomised (allocation concealed), unblinded, controlled trial with 28 days of follow up. The trial was stopped after 861 patients were enrolled.


10 university centres in the US.


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, …

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  • Source of funding: National Heart, Lung, and Blood Institute.

  • For correspondence: Dr R G Brower, Division of Pulmonary and Critical Care Medicine, Johns Hopkins University, 600 N Wolfe Street, Baltimore, MD 21287, USA. Fax +1 410 955 0036.

  • A modified version of this abstract appears in ACP Journal Club and Evidence-Based Medicine.