Using low tidal volume ventilation.
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| Posted By: | Gordon Doig |
| Email: | gdoig@med.usyd.edu.au |
| URL: | |
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Although some claim that they don't use the ARDSNet low tidal volume ventilation protocol because they already use 'lower' tidal volumes than were delivered in the control arm in the ARDSNet study, this is a nefarious argument. Recent observational studies have shown we may not be as consistent in using 'lower' tidal volumes as we think we are. In an Australian observational study, the average Vt in ml/kg on day 1 of ARDS/ALI was 9.7 ± 1.9 (Online Data Supplement to Incidence and Mortality of Acute Lung Injury and the Acute Respiratory Distress Syndrome in Three Australian States). This would suggest that perhaps as few as 16% of patients are being ventilated at or below 8 ml/kg Predicted Body Weight while 50% of patients were being ventilated with over 10mls/kg. The ARDSNet ventilation protocol is supported by Level I evidence. It may be that 'lower' (8-10ml/kg) tidal volume ventilation is better than high (12ml/kg), however there is no evidence to suggest that 'lower' is better than low (6ml/kg). Until additional objective evidence is presented, it is most reasonable to assume that patients are more likely to benefit from low tidal volume ventilation. |
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 Using low tidal volume ventilation. By:Gordon Doig |
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[ Back ] Any questions or comments please contact gdoig@med.usyd.edu.au Implemented and designed by John Soer and Gordon Doig Page last modified on Wednesday February 8, 2000 |
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