ReviewAmerican journal of respiratory and critical care medicine2017
Fifty Years of Research in ARDS. Vt Selection in Acute Respiratory Distress Syndrome.
Review in American journal of respiratory and critical care medicine, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 28 papers, 1 of them a synthesis that pooled it.
What it found
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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
28 citing papers in PubMed, 1 synthesis or guideline pooled it.
- An Update on Management of Adult Patients with Acute Respiratory Distress Syndrome: An Official American Thoracic Society Clinical Practice Guideline.American journal of respiratory and critical care medicine · 2024Guideline
- Electric impedance tomography-guided PEEP titration reduces mechanical power in ARDS: a randomized crossover pilot trial.Critical care (London, England) · 2023Trial
- Randomized Feasibility Trial of a Low Tidal Volume-Airway Pressure Release Ventilation Protocol Compared With Traditional Airway Pressure Release Ventilation and Volume Control Ventilation Protocols.Critical care medicine · 2018Trial
- Acute Respiratory Distress Syndrome: Pathophysiological Insights, Subphenotypes, and Clinical Implications-A Comprehensive Review.Journal of clinical medicine · 2025Review
- A bibliometric analysis of respiratory mechanics research related to acute respiratory distress syndrome from 1985 to 2023.Frontiers in medicine · 2024Article
- Acute respiratory distress syndrome in patients with COVID-19 vs. Non-COVID-19: clinical characteristics and outcomes in a tertiary care setting in Mexico City.BMC pulmonary medicine · 2023Observational
- Analysis of predictors of mortality and clinical outcomes of different subphenotypes for moderate-to-severe pediatric acute respiratory distress syndrome: A prospective single-center study.Frontiers in pediatrics · 2022Article
- Interpretation and use of intraoperative protective ventilation parameters: a scoping review.Anaesthesiology intensive therapy · 2022Article
- Association of different positive end-expiratory pressure selection strategies with all-cause mortality in adult patients with acute respiratory distress syndrome.Systematic reviews · 2021Article
- COVID-19 versus Non-COVID-19 Acute Respiratory Distress Syndrome: Comparison of Demographics, Physiologic Parameters, Inflammatory Biomarkers, and Clinical Outcomes.Annals of the American Thoracic Society · 2021Observational
- Development and validation of a reinforcement learning algorithm to dynamically optimize mechanical ventilation in critical care.NPJ digital medicine · 2021Article
- ECCOFrontiers in medicine · 2021Article
- Automatic detection of reverse-triggering related asynchronies during mechanical ventilation in ARDS patients using flow and pressure signals.Journal of clinical monitoring and computing · 2020Article
- Alveolar CCN1 is associated with mechanical stretch and acute respiratory distress syndrome severity.American journal of physiology. Lung cellular and molecular physiology · 2020Article
- Physiologically variable ventilation reduces regional lung inflammation in a pediatric model of acute respiratory distress syndrome.Respiratory research · 2020Article
- Extracorporeal carbon dioxide removal requirements for ultraprotective mechanical ventilation: Mathematical model predictions.Artificial organs · 2020Article
- Volume Guarantee High-Frequency Oscillatory Ventilation in Preterm Infants With RDS: Tidal Volume and DCOFrontiers in pediatrics · 2020Article
- A Physiologically Informed Strategy to Effectively Open, Stabilize, and Protect the Acutely Injured Lung.Frontiers in physiology · 2020Review
- Association between hospital mortality and inspiratory airway pressures in mechanically ventilated patients without acute respiratory distress syndrome: a prospective cohort study.Critical care (London, England) · 2019Observational
- Feasibility and safety of ultra-low tidal volume ventilation without extracorporeal circulation in moderately severe and severe ARDS patients.Intensive care medicine · 2019Article
Corrections and comments
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Authors and funding
3 authors.
Funding
Abstract
Mechanical ventilation (MV) is critical in the management of many patients with acute respiratory distress syndrome (ARDS). However, MV can also cause ventilator-induced lung injury (VILI). The selection of an appropriate Vt is an essential part of a lung-protective MV strategy. Since the publication of a large randomized clinical trial demonstrating the benefit of lower Vts, the use of Vts of 6 ml/kg predicted body weight (based on sex and height) has been recommended in clinical practice guidelines. However, the predicted body weight approach is imperfect in patients with ARDS because the amount of aerated lung varies considerably due to differences in inflammation, consolidation, flooding, and atelectasis. Better approaches to setting Vt may include limits on end-inspiratory transpulmonary pressure, lung strain, and driving pressure. The limits of lowering Vt have not yet been established, and some patients may benefit from Vts that are lower than those in current use. However, lowering Vts may result in respiratory acidosis. Tactics to reduce respiratory acidosis include reductions in ventilation circuit dead space, increases in respiratory rate, higher positive end-expiratory pressures in patients who recruit lung in response to positive end-expiratory pressure, recruitment maneuvers, and prone positioning. Mechanical adjuncts such as extracorporeal carbon dioxide removal may be useful to normalize pH and carbon dioxide levels, but further studies will be necessary to demonstrate benefit with this technology.
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