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Mechanical Ventilation 101

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Handbook of Evidence-Based Critical Care

Abstract

A landmark study published by the ARDSNet group (NIH ARDS Network) in 2000 demonstrated that volume-assisted ventilation (AC) with a low tidal volume (6 ml/kg of predicted body weight) was associated with a significant reduction in 28-day all-cause mortality as compared to AC ventilation with traditional tidal volumes (12 ml/kg of PBW) in patients with ARDS.1 Such an approach is now considered the standard of care and applies to all mechanically ventilated patients, not just those with ARDS.24

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References

  1. Ventilation with lower tidal volumes as compared with traditional tidal volumes for acute lung injury and the acute respiratory distress syndrome. N Engl J Med. 2000;342:1301–1308.

    Google Scholar 

  2. Girard TD, Bernard GR. Mechanical ventilation in ARDS: a state-of-the-art review. Chest. 2007;131:921–929.

    Article  PubMed  Google Scholar 

  3. Wheeler AP, Bernard GR. Acute lung injury and the acute respiratory distress syndrome: a clinical review. Lancet. 2007;369:1553–1565.

    Article  PubMed  Google Scholar 

  4. Malhotra A. Low-tidal-volume ventilation in the acute respiratory distress syndrome. N Engl J Med. 2007;357:1113–1120.

    Article  PubMed  CAS  Google Scholar 

  5. Gajic O, Dara SI, Mendez JL, et al. Ventilator-associated lung injury in patients without acute lung injury at the onset of mechanical ventilation. Crit Care Med. 2004;32:1817–1824.

    Article  PubMed  Google Scholar 

  6. Gajic O, Frutos-Vivar F, Esteban A, et al. Ventilator settings as a risk factor for acute respiratory distress syndrome in mechanically ventilated patients. Intensive Care Med. 2005;31:922–926.

    Article  PubMed  Google Scholar 

  7. Lee PC, Helsmoortel CM, Cohn SM, et al. Are low tidal volumes safe? Chest. 1990;97:430–434.

    Article  PubMed  CAS  Google Scholar 

  8. Myers TR, MacIntyre N. Does airway pressure release ventilation offer important new advantages in mechanical ventilator support? Resp Care. 2007;52:452–458.

    Google Scholar 

  9. Hemmila MR, Napolitano LM. Severe respiratory failure: advanced treatment options. Crit Care Med. 2006;34:S278–S290.

    PubMed  CAS  Google Scholar 

  10. Rose L, Hawkins M. Airway pressure release ventilation and biphasic positive airway pressure: a systematic review of definitional criteria. Intensive Care Med. 2008;34:1766–1773.

    Article  PubMed  Google Scholar 

  11. Neumann P, Golisch W, Strohmeyer A, et al. Influence of different release times on spontaneous breathing pattern during airway pressure release ventilation. Intensive Care Med. 2002;28:1742–1749.

    Article  PubMed  Google Scholar 

  12. Hirani A, Cavallazzi R, Shnister A, et al. Airway pressure release ventilation (APRV) for treatment of severe life-threatening ARDS in a morbidly obese patient. Crit Care Shock. 2008;11:132–136.

    Google Scholar 

  13. Gilbert C, Marik PE, Varon J. Acute lobar atelectasis during mechanical ventilation: to beat, suck or blow? Crit Care Shock. 2009;12:67–70.

    Google Scholar 

  14. Hirani A, Plante LA, Marik PE. Airway pressure release ventilation in pregnant patients with ARDS: a novel strategy. Resp Care. 2009; 54:1405–1408.

    Google Scholar 

  15. Manzano F, Fernandez-Mondejar E, Colmenero M, et al. Positive-end expiratory pressure reduces incidence of ventilator-associated pneumonia in nonhypoxemic patients. Crit Care Med. 2008;36:2225–2231.

    Article  PubMed  Google Scholar 

  16. MacIntyre NR, Cook DJ, Ely EW Jr., et al. Evidence-based guidelines for weaning and discontinuing ventilatory support: a collective task force facilitated by the American College of Chest Physicians; the American Association for Respiratory Care; and the American College of Critical Care Medicine. Chest. 2001;120:375S–395S.

    Article  PubMed  CAS  Google Scholar 

  17. Rumbak MJ, Newton M, Truncale T, et al. A prospective, randomized, study comparing early percutaneous dilational tracheotomy to prolonged translaryngeal intubation (delayed tracheotomy) in critically ill medical patients. Crit Care Med. 2004;32:1689–1694.

    Article  PubMed  Google Scholar 

  18. Kollef MH, Ahrens TS, Shannon W. Clinical predictors and outcomes for patients requiring tracheostomy in the intensive care unit. Crit Care Med. 1999;27:1714–1720.

    Article  PubMed  CAS  Google Scholar 

  19. Flaatten H, Gjerde S, Heimdal JH, et al. The effect of tracheostomy on outcome in intensive care unit patients. Acta Anaesthesiol Scand. 2006;50:92–98.

    Article  PubMed  CAS  Google Scholar 

  20. Barquist ES, Amortegui J, Hallal A, et al. Tracheostomy in ventilator dependent trauma patients: a prospective, randomized intention-to-treat study. J Trauma. 2006;60:91–97.

    Article  PubMed  Google Scholar 

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Correspondence to Paul Ellis Marik MBBCh, FCP(SA), FRCP(C), FCCP, FCCM, FACP, MD .

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Marik, P.E. (2010). Mechanical Ventilation 101. In: Handbook of Evidence-Based Critical Care. Springer, New York, NY. https://doi.org/10.1007/978-1-4419-5923-2_14

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  • DOI: https://doi.org/10.1007/978-1-4419-5923-2_14

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  • Publisher Name: Springer, New York, NY

  • Print ISBN: 978-1-4419-5922-5

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