Mechanical ventilation with a lower tidal volume reduces 28-day mortality in adults with acute respiratory distress syndrome or acute lung injury

Added March 19, 2020

Citation: Petrucci N, De Feo C. Lung protective ventilation strategy for the acute respiratory distress syndrome. Cochrane Database of Systematic Reviews 2013; (2): CD003844

What is this? Some patients with COVID-19 will develop acute respiratory distress syndrome (ARDS) or acute lung injury (ALI) and need help with their breathing. This might be provided by mechanical ventilation (MV) in an intensive care unit (ICU). However, complications such as ventilator-induced lung injury may arise with MV. Lung protective ventilation strategies involving gentler forms of MV are widely used to prevent this.

In this Cochrane systematic review, the authors searched for randomized trials of the effects of ventilation with lower tidal volume in adults with ARDS or ALI who are receiving MV. They did not restrict by language of publication and did their searches in September 2012. They identified six randomised trials (1297 participants).

What works: Using mechanical ventilation with a lower tidal volume reduces 28-day mortality for adult ICU patients.

What doesn’t work: Nothing noted.

What’s uncertain: The effects of different lung-protective ventilation strategies on mortality over the long-term is uncertain.


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