tailieunhanh - Báo cáo y học: " Mechanical ventilation: lessons from the ARDSNet trial"

Tuyển tập các báo cáo nghiên cứu về y học được đăng trên tạp chí y học 'Respiratory Research cung cấp cho các bạn kiến thức về ngành y đề tài: Mechanical ventilation: lessons from the ARDSNet trial. | http content 1 2 073 Commentary Mechanical ventilation lessons from the ARDSNet trial Arthur S Slutsky and V Marco Ranieri St Michael s Hospital University of Toronto Toronto Canada and Ospedale Sanata Chiara Università di Pisa Pisa Italy o 3 I Received 17 July 2000 Revisions requested 17 August 2000 Revisions received 18 August 2000 Accepted 18 August 2000 Published 31 August 2000 Respir Res 2000 1 73-77 Current Science Ltd Print ISSN 1465-9921 Online ISSN 1465-993X Abstract The acute respiratory distress syndrome ARDS is an inflammatory disease of the lungs characterized clinically by bilateral pulmonary infiltrates decreased pulmonary compliance and hypoxemia. Although supportive care for ARDS seems to have improved over the past few decades few studies have shown that any treatment can decrease mortality for this deadly syndrome. In the 4 May 2000 issue of New England Journal of Medicine the results of an NIH-sponsored trial were presented they demonstrated that the use of a ventilatory strategy that minimizes ventilator-induced lung injury leads to a 22 decrease in mortality. The implications of this study with respect to clinical practice further ARDS studies and clinical research in the critical care setting are discussed. Keywords acute lung injury artificial respiration barotrauma biotrauma iatrogenic respiratory failure Introduction ARDS is an inflammatory disease of the lungs characterized clinically by bilateral pulmonary infiltrates decreased pulmonary compliance and hypoxemia 1 2 . Despite intense research for decades the mortality rate in patients with ARDS remains very high although there is some evidence that these rates might be decreasing 3 . Interestingly although the major initial physiological abnormalities are often pulmonary in origin patients who go on to die of their acute illness usually die of multiple system organ failure MSOF rather than a respiratory death ie hypoxemia . Virtually all patients with ARDS .