Effect of a protective-ventilation strategy on mortality in the acute respiratory distress syndrome

New England Journal of Medicine

Volumn 338, Issue 6, 1998, Pages 347-354

  Amato, Marcelo Britto Passos ^a,c   Barbas, Carmen Silvia Valente ^a   Medeiros, Denise Machado ^a   Magaldi, Ricardo Borges ^a   Schettino, Guilherme De Paula Pinto ^a   Lorenzi Filho, Geraldo ^a   Kairalla, Ronaldo Adib ^a   Deheinzelin, Daniel ^a   Munoz, Carlos ^b   Oliveira, Roselaine ^b   Takagaki, Teresa Yae ^a   Carvalho, Carlos Roberto Ribeiro ^a  

^a UNIVERSITY OF SÃO PAULO   (Brazil)

^b Santa Casa de Misericordia de Goiania   (Brazil)

^c NONE   (Brazil)

Author keywords

[No Author keywords available]

Indexed keywords

ADULT; ADULT RESPIRATORY DISTRESS SYNDROME; ARTICLE; ARTIFICIAL VENTILATION; BAROTRAUMA; CONTROLLED STUDY; HUMAN; HYPERCAPNIA; LUNG COMPLICATION; MAJOR CLINICAL STUDY; MORTALITY; POSITIVE END EXPIRATORY PRESSURE; PRESSURE VOLUME CURVE; PRIORITY JOURNAL; STATISTICAL ANALYSIS; TISSUE OXYGENATION;

EID: 0032484956     PISSN: 00284793     EISSN: None     Source Type: Journal    
DOI: 10.1056/NEJM199802053380602     Document Type: Article

References (44)

1. Snyder JV, Froese A. Respirator lung. In: Snyder JV, Pinsky MR, eds. Oxygen transport in the critically ill. Chicago: Year Book Medical Publishers, 1987:358-73.
2. Marini JJ. Ventilation of the acute respiratory distress syndrome: looking for Mr. Goodmode. Anesthesiology 1994;80:972-5.
3. Fu Z, Costello ML, Tsukimoto K, et al. High lung volume increases stress failure in pulmonary capillaries. J Appl Physiol 1992;73:123-33.
4. Carlton DP, Cummings JJ, Scheerer RG, Poulain FR, Bland RD. Lung overexpansion increases pulmonary microvascular protein permeability in young lambs. J Appl Physiol 1990;69:577-83.
5. Parker JC, Hernandez LA, Longenecker GL, Peevy K, Johnson W. Lung edema caused by high peak inspiratory pressures in dogs: role of increased microvascular filtration pressure and permeability. Am Rev Respir Dis 1990;142:321-8.
6. Tsuno K, Prato P, Kolobow T. Acute lung injury from mechanical ventilation at moderately high airway pressures. J Appl Physiol 1990;69:956-61.
7. Dreyfuss D, Saumon G. Role of tidal volume, FRC, and end-inspiratory volume in the development of pulmonary edema following mechanical ventilation. Am Rev Respir Dis 1993;148:1194-203.
8. Hickling KG, Henderson SJ, Jackson R. Low mortality associated with low volume pressure limited ventilation with permissive hypercapnia in severe adult respiratory distress syndrome. Intensive Care Med 1990;16:372-7.
9. Hickling KG, Walsh J, Henderson S, Jackson R. Low mortality rate in adult respiratory distress syndrome using low-volume, pressure-limited ventilation with permissive hypercapnia: a prospective study. Crit Care Med 1994;22:1568-78.
10. 2 removal in severe acute respiratory failure. JAMA 1986;256:881-6.
11. Lee PC, Helsmoortel CM, Cohn SM, Fink MP. Are low tidal volumes safe? Chest 1990;97:430-4.
12. Mathieu-Costello O, Willford DC, Fu Z, Garden RM, West JB. Pulmonary capillaries are more resistant to stress failure in dogs than in rabbits. J Appl Physiol 1995;79:908-17.
13. Albert RK. Least PEEP: primum non nocere. Chest 1985;87:2-4.
14. Petty TL. The use, abuse, and mystique of positive end-expiratory pressure. Am Rev Respir Dis 1988;138:475-8.
15. Amato MBP, Barbas CSV, Medeiros DM, et al. Beneficial effects of the "open lung approach" with low distending pressures in acute respiratory distress syndrome: a prospective randomized study on mechanical ventilation. Am J Respir Crit Care Med 1995;152:1835-46.
16. Carvalho CRR, Barbas CSV, Medeiros DM, et al. Temporal hemodynamic effects of permissive hypercapnia associated with ideal PEEP in ARDS. Am J Respir Crit Care Med 1997;156:1458-66.
17. Murray JF, Matthay MA, Luce JM, Flick MR. An expanded definition of the adult respiratory distress syndrome. Am Rev Respir Dis 1988;138:720-3. [Erratum, Am Rev Respir Dis 1989;139:1065.]
18. Teboul JL, Besbes M, Andrivet P, et al. A bedside index assessing the reliability of pulmonary artery occlusion pressure measurements during mechanical ventilation with positive end-expiratory pressure. J Crit Care 1992;7:22-9.
19. Yeung HC, Lu MW, Martinez EG, Puri VK. Critical Care Scoring System - new concept based on hemodynamic data. Crit Care Med 1990;18:1347-52.
20. Smith PEM, Gordon IJ. An index to predict outcome in adult respiratory distress syndrome. Intensive Care Med 1986;12:86-9.
21. Knaus WA, Draper EA, Wagner DP, Zimmerman JE. Apache II: a severity of disease classification system. Crit Care Med 1985;13:818-29.
22. Amato MBP, Barbas CSV, Meyer EC, Grunauer MA, Magaldi RB, Carvalho CRR. Setting the "best PEEP" in ARDS: limitations of choosing the PEEP according to the "best compliance." Am J Respir Crit Care Med 1995;151:Suppl:A550. abstract.
23. Amato MBP, Barbas CSV, Bonassa J, Saldiva PHN, Zin WA, Carvalho CRR. Volume-assured pressure support ventilation (VAPSV): a new approach for reducing muscle workload during acute respiratory failure. Chest 1992;102:1225-34.
24. 2 removal. In: Lemaire F, ed. Mechanical ventilation. Berlin, Germany: Springer-Verlag, 1991:129-45.
25. Pocock SJ. When to stop a clinical trial. BMJ 1992;305:235-40.
26. Peto R, Pike MC, Armitage P, et al. Design and analysis of randomized clinical trials requiring prolonged observation of each patient. I. Introduction and design. Br J Cancer 1976;34:585-612.
27. Geller NL, Pocock SJ. Interim analysis in randomized clinical trials: ramifications and guidelines for practitioners. Biometrics 1987;43:213-23.
28. Pocock SJ, Hughes MD. Estimation issues in clinical trials and overviews. Stat Med 1990;9:657-71.
29. Muscedere JG, Mullen JBM, Gan K, Slutsky AS. Tidal ventilation at low airway pressures can augment lung injury. Am J Respir Crit Care Med 1994;149:1327-34.
30. Bshouty Z, Ali J, Younes M. Effect of tidal volume and PEEP on rate of edema formation in in situ perfused canine lobes. J Appl Physiol 1988;64:1900-7.
31. Sandhar BK, Niblett DJ, Argiras EP, Dunnill MS, Sykes MK. Effects of positive end-expiratory pressure on hyaline membrane formation in a rabbit model of the neonatal respiratory distress syndrome. Intensive Care Med 1988;14:538-46.
32. Argiras EP, Blakeley CR, Dunnill MS, Otremski S, Sykes MK. High PEEP decreases hyaline membrane formation in surfactant deficient lungs. Br J Anaesth 1987;59:1278-85.
33. Wyszogrodski I, Kyei-Aboagye K, Taeusch HW Jr, Avery ME. Surfactant inactivation by hyperventilation: conservation by end-expiratory pressure. J Appl Physiol 1975;38:461-6.
34. Edmonds HL Jr, Spohr RW, Finnegan RF, et al. Indomethacin pretreatment in continuous positive-pressure ventilation. Crit Care Med 1981;9:524-9.
35. Tremblay L, Valenza F, Ribeiro SP, Li J, Slutsky AS. Injurious ventilatory strategies increase cytokines and c-fos m-RNA expression in an isolated rat lung model. J Clin Invest 1997;99:944-52.
36. Sugiura M, McCulloch PR, Wren S, Dawson RH, Froese AB. Ventilator pattern influences neutrophil influx and activation in atelectasis-prone rabbit lung. J Appl Physiol 1994;77:1355-65.
37. Tilson MD, Bunke MC, Smith GJ, et al. Quantitative bacteriology and pathology of the lung in experimental Pseudomonas pneumonia treated with positive end-expiratory pressure (PEEP). Surgery 1977;82:133-40.
38. Johanson WG Jr, Higuchi JH, Woods DE, Gomez P, Coalson JJ. Dissemination of Pseudomonas aeruginosa during lung infection in hamsters: role of oxygen-induced lung injury. Am Rev Respir Dis 1985;132:358-61.
39. Nahum A, Hoyt J, McKibben A, et al. Effect of mechanical ventilation strategy on E. coli pneumonia in dogs. Am J Respir Crit Care Med 1996;153:Suppl:A531. abstract.
40. Marini JJ, Culver BH. Systemic gas embolism complicating mechanical ventilation in the adult respiratory distress syndrome, Ann Intern Med 1989;110:699-703.
41. Gregory GA, Tooley WH. Gas embolism in hyaline-membrane disease. N Engl J Med 1970;282:1141-2.
42. Mathru M, Rao TLK, Venus B. Ventilator-induced barotrauma in controlled mechanical ventilation versus intermittent mandatory ventilation. Crit Care Med 1983;11:359-61.
43. Petersen GW, Baier H. Incidence of pulmonary barotrauma in a medical ICU. Crit Care Med 1983;11:67-9.
44. Zwillich CW, Pierson DJ, Creagh CE, Sutton FD, Schatz E, Petty TL. Complications of assisted ventilation: a prospective study of 354 consecutive episodes. Am J Med 1974;57:161-70.