Protective mechanical ventilation: revision of randomized clinical trials

Authors

  • Bruno Valle Pinheiro Núcleo de Pesquisa em Pneumologia e Terapia Intensiva, Departamento de Clínica Médica, Faculdade de Medicina da Universidade Federal de Juiz de Fora
  • Cristiane Bastos Netto Unidade de Cuidados Intensivos do Hospital Universitário, Universidade Federal de Juiz de Fora
  • Rodrigo Souza Vieira Unidade de Cuidados Intensivos do Hospital Universitário, Universidade Federal de Juiz de Fora
  • Mateus Pinto Botelho Núcleo de Pesquisa em Pneumologia e Terapia Intensiva, Departamento de Clínica Médica, Faculdade de Medicina da Universidade Federal de Juiz de Fora
  • Gabrielle de Moura Lopes Núcleo de Pesquisa em Pneumologia e Terapia Intensiva, Departamento de Clínica Médica, Faculdade de Medicina da Universidade Federal de Juiz de Fora
  • Maycon Moura Reboredo Núcleo de Pesquisa em Pneumologia e Terapia Intensiva, Departamento de Clínica Médica, Faculdade de Medicina da Universidade Federal de Juiz de Fora

DOI:

https://doi.org/10.34019/1982-8047.2019.v45.28988

Keywords:

Respiration, Artificial, Lung Injury, Mortality

Abstract

Introduction: Mechanical ventilation can be a life-saving strategy in patients with respiratory failure. However, it is potentially dangerous and can induce a so-called ventilator-induced lung injury (VILI). This revision aimed to analyze the results of randomized clinical trials (RCT) that evaluated the impact of ventilatory settings on mortality. Material and methods: We search in PubMed for RCT, published from 1980 to 2019, using the following MeSH terms: “respiratory distress syndrome, adult” and “respiration, artificial”. We selected the RCT that compared different ventilatory settings and had mortality as an outcome. Results: In patients with acute respiratory distress syndrome (ARDS), it has been demonstrated that limiting tidal volume, plateau pressure, and driving pressure reduced mortality. In severe ARDS, the use of higher PEEP and prone position also reduced mortality. Among non-ARDS patients, it is still uncertain if any strategy is associated with better survival rates. Conclusion: In ARDS patients, one has to be aware of setting the ventilatory parameters because protective settings can improve survival.

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Published

2019-11-28

How to Cite

1.
Valle Pinheiro B, Bastos Netto C, Souza Vieira R, Pinto Botelho M, de Moura Lopes G, Moura Reboredo M. Protective mechanical ventilation: revision of randomized clinical trials. HU Rev [Internet]. 2019Nov.28 [cited 2024Nov.21];45(3):334-40. Available from: https://periodicos.ufjf.br/index.php/hurevista/article/view/28988

Issue

Vol. 45 No. 3 (2019): HU Revista 45 anos - Edição Comemorativa

Section

Artigos de Revisão da Literatura

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