• Ravi Kalhan, Mark Mikkelsen, Pali Dedhiya, Jason Christie, Christine Gaughan, Paul N Lanken, Barbara Finkel, Robert Gallop, and Barry D Fuchs.
• Division of Pulmonary and Critical Care, Northwestern University Feinberg School of Medicine, Chicago, IL, USA.
• Crit. Care Med. 2006 Feb 1; 34 (2): 300-6.

ObjectiveTo determine the frequency of use of low-tidal-volume ventilation in appropriate patients with acute lung injury (ALI) and the factors associated with the choice of tidal volume.DesignProspective observational cohort study of patients identified with ALI or acute respiratory distress syndrome from September 2000 to November 2002.SettingMedical and surgical intensive care unit (ICU) at an academic tertiary-care hospital.Measurements And Main ResultsMeasurements included the proportion for whom the ventilation tidal volume (TV) was 8.5 mL/kg/PBW on day 2 of ALI, 30% on day 4, and 24% on day 7. The use of low TV was significantly associated with clinical parameters indicative of worse disease severity, including low values for Pao2 (p = .01), Pao2/Fio2 (p = .08), and static compliance of the respiratory system (p = .006).ConclusionsVentilation with a low TV was used in a minority of patients with ALI, despite results published in 1998 and 2000 supporting this approach. This may be related to clinicians' underrecognition of less severe cases of ALI, their reserving of low-TV ventilation for more severe cases, or both.

17 keywords...

hide…