ArticleAmerican journal of respiratory and critical care medicine2008
Effects of a clinical trial on mechanical ventilation practices in patients with acute lung injury.
Article in American journal of respiratory and critical care medicine, 2008. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 47 papers, 3 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
47 citing papers in PubMed, 3 syntheses or guidelines pooled it.
- Surviving Sepsis Campaign: International Guidelines for Management of Sepsis and Septic Shock: 2016.Intensive care medicine · 2017Guideline
- Surviving Sepsis Campaign: international guidelines for management of severe sepsis and septic shock, 2012.Intensive care medicine · 2013Guideline
- Lower tidal volume at initiation of mechanical ventilation may reduce progression to acute respiratory distress syndrome: a systematic review.Critical care (London, England) · 2013Pooled it
- Timing of low tidal volume ventilation and intensive care unit mortality in acute respiratory distress syndrome. A prospective cohort study.American journal of respiratory and critical care medicine · 2015Trial
- Beyond One-Size-Fits-All: Precision Mechanical Ventilation in ARDS.Journal of clinical medicine · 2026Review
- Preferences for mechanical ventilation modes among intensivists in Türkiye: a nationwide point-prevalence study.Turkish journal of medical sciences · 2026Article
- Optimizing Mechanical Ventilation Strategies in ARDS: The Role of Driving Pressure and Low Tidal Volume Ventilation.Critical care research and practice · 2025Review
- Adaptive Pressure Control-Continuous Mandatory Ventilation Versus Volume Control-Continuous Mandatory Ventilation: Factors Associated With Initiation, Maintenance, and Adjustment.Respiratory care · 2024Article
- Validation of a tool for estimating clinician recognition of ARDS using data from the international LUNG SAFE study.PLOS digital health · 2023Article
- The first step is recognizing there is a problem: a methodology for adjusting for variability in disease severity when estimating clinician performance.BMC medical research methodology · 2022Article
- Use of a Portable Electronic Interface Improves Clinical Handoffs and Adherence to Lung Protective Ventilation.Medical devices (Auckland, N.Z.) · 2022Article
- Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021.Intensive care medicine · 2021Article
- Influence of ventilatory strategies on outcomes and length of hospital stay: assist control and synchronized intermittent mandatory ventilation modes.Internal and emergency medicine · 2021Article
- Obesity Attenuates Ventilator-Induced Lung Injury by Modulating the STAT3-SOCS3 Pathway.Frontiers in immunology · 2021Article
- Use of pressure-regulated volume control in the first 48 hours of hospitalization of mechanically ventilated patients with sepsis or septic shock, with or without ARDS.Journal of the Intensive Care Society · 2020Article
- Article
- Low tidal volume ventilation use remains low in patients with acute respiratory distress syndrome at a single center.Journal of critical care · 2018Article
- Observational
- A Critical Care Clinician Survey Comparing Attitudes and Perceived Barriers to Low Tidal Volume Ventilation with Actual Practice.Annals of the American Thoracic Society · 2017Article
- Why do we fail to deliver evidence-based practice in critical care medicine?Current opinion in critical care · 2017Review
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
5 authors.
Funding
Abstract
rationaleIn a clinical trial by the Acute Respiratory Distress Syndrome Network (ARDSNet), mechanical ventilation with tidal volumes of 6 ml/kg decreased mortality from acute lung injury. However, interpretations of these results generated controversy and it was unclear if this trial would change usual-care practices.
objectivesFirst, to determine if clinical practices at ARDSNet hospitals changed after the tidal volume trial. Second, to determine if tidal volume and plateau pressure (Pplat) within 48 hours before randomization affected hospital mortality in patients subsequently managed with 6 ml/kg predicted body weight (PBW).
methodsWe used preenrollment data from 2,451 patients enrolled in six trials (1996-2005) to describe changes in tidal volume over time. We used logistic regression to determine if preenrollment tidal volume or Pplat affected mortality. MEASUREMENTS AND MAIN
resultsMedian preenrollment tidal volume decreased from 10.3 ml/kg PBW (range, 4.3-17.1) during the tidal volume trial (1996-1999) to 7.3 ml/kg PBW (range, 3.9-16.2) after its completion (P < 0.001). Preenrollment tidal volume was not associated with mortality (P = 0.566). The odds of death increased multiplicatively with each cm H(2)O of preenrollment Pplat (P < 0.001) (e.g., the odds of death was 1.37 times greater when preenrollment Pplat increased by 10 cm H(2)O).
conclusionsPhysicians used lower tidal volumes after publication of the tidal volume trial. Preenrollment Pplat was strongly associated with mortality, and may reflect disease severity independent of tidal volume. Pplat measured early in the course of acute lung injury, after accounting for tidal volume, is a respiratory system-specific value with strong prognostic significance.
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Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.