ArticleBMJ (Clinical research ed.)2012
Lung protective mechanical ventilation and two year survival in patients with acute lung injury: prospective cohort study.
Article in BMJ (Clinical research ed.), 2012. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to 5 registered trials, which are not on this map. Cited by 146 papers, 7 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.
The Improving Care of Acute Lung Injury Patients (ICAP) Study
Effects of Different Ventilation Modes on Intraoperative Lung Injury and Postoperative Pulmonary Complications in Elderly Patients Undergoing Laparoscopic Colorectal Cancer Resection
Multicenter Observational Study on Practice of Ventilation in Brain Injured Patients
Safety and Efficacy of Low-Flow ECMO in a Multi-modal Cohort of Adults in Respiratory Failure
Pneumococcal Community-Acquired Pneumonia Requiring Hospitalization Among Colombian Adults (Pneumo-CAP Colombia)
Who cites it
146 citing papers in PubMed, 7 syntheses or guidelines pooled it, 348 citations in OpenAlex.
- Guidelines on the management of acute respiratory distress syndrome.BMJ open respiratory research · 2019Guideline
- Role of Neuromuscular Blocking Agents in Acute Respiratory Distress Syndrome: An Updated Meta-Analysis of Randomized Controlled Trials.Frontiers in pharmacology · 2019Pooled it
- Prone position for acute respiratory failure in adults.The Cochrane database of systematic reviews · 2015Pooled it
- Exercise rehabilitation following intensive care unit discharge for recovery from critical illness.The Cochrane database of systematic reviews · 2015Pooled it
- Mechanical ventilation during extracorporeal life support (ECLS): a systematic review.Intensive care medicine · 2015Pooled it
- Tidal volume and plateau pressure use for acute lung injury from 2000 to present: a systematic literature review.Critical care medicine · 2014Pooled it
- 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
- Trial
- Effect of Early High-Dose Vitamin D3 Repletion on Cognitive Outcomes in Critically Ill Adults.Chest · 2021Trial
- Simulation Training for Residents Focused on Mechanical Ventilation: A Randomized Trial Using Mannequin-Based Versus Computer-Based Simulation.Simulation in healthcare : journal of the Society for Simulation in Healthcare · 2017Trial
- Trial
- Exercise-based rehabilitation after hospital discharge for survivors of critical illness with intensive care unit-acquired weakness: A pilot feasibility trial.Journal of critical care · 2015Trial
- Trial
- Trial
- 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
- The relationship between positive end-expiratory pressure and cardiac index in patients with acute respiratory distress syndrome.Journal of critical care · 2013Trial
- Physical and cognitive performance of patients with acute lung injury 1 year after initial trophic versus full enteral feeding. EDEN trial follow-up.American journal of respiratory and critical care medicine · 2013Trial
- Bench evidence, bedside uncertainty: hyperoxia, mechanical ventilation and lung injury.European respiratory review : an official journal of the European Respiratory Society · 2026Review
- Deep knowledge-driven multi-modal fusion for diagnosis and prognosis of SI-ARDS.Communications medicine · 2026Article
- Waveform data capture substantial variation in tidal volume and other respiratory parameters.Annals of the American Thoracic Society · 2026Article
86 more citing papers are in PubMed but not listed here.
Corrections and comments
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Authors and funding
10 authors at 3 institutions in 1 country.
Funding
Abstract
objectiveTo evaluate the association of volume limited and pressure limited (lung protective) mechanical ventilation with two year survival in patients with acute lung injury.
designProspective cohort study.
setting13 intensive care units at four hospitals in Baltimore, Maryland, USA.
participants485 consecutive mechanically ventilated patients with acute lung injury.
main outcome measureTwo year survival after onset of acute lung injury.
results485 patients contributed data for 6240 eligible ventilator settings, as measured twice daily (median of eight eligible ventilator settings per patient; 41% of which adhered to lung protective ventilation). Of these patients, 311 (64%) died within two years. After adjusting for the total duration of ventilation and other relevant covariates, each additional ventilator setting adherent to lung protective ventilation was associated with a 3% decrease in the risk of mortality over two years (hazard ratio 0.97, 95% confidence interval 0.95 to 0.99, P=0.002). Compared with no adherence, the estimated absolute risk reduction in two year mortality for a prototypical patient with 50% adherence to lung protective ventilation was 4.0% (0.8% to 7.2%, P=0.012) and with 100% adherence was 7.8% (1.6% to 14.0%, P=0.011).
conclusionsLung protective mechanical ventilation was associated with a substantial long term survival benefit for patients with acute lung injury. Greater use of lung protective ventilation in routine clinical practice could reduce long term mortality in patients with acute lung injury.
trial registrationClinicaltrials.gov NCT00300248.
Indexed as
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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.