TY - JOUR
T1 - Are low tidal volumes safe?
AU - Lee, P. G.
AU - Helsmoortel, C. M.
AU - Cohn, S. M.
AU - Fink, M. P.
N1 - Funding Information:
We gratefully acknowledge the support of the Surgical Intensive Care Unit nurses at the University of Massachusetts Medical Center. Stephen O. Heard, M.D., reviewed the manuscript and provided us with insightful and informative guidance. Carol Powers retrieved dozens of charts from medical records. Sandy Hinson, Penny Lucier, and Michelle Tremblay assisted in preparation of the manuscript.
PY - 1990
Y1 - 1990
N2 - High airway pressure may be injurious to lung parenchyma, but lowering airway pressure using conventional mechanical ventilation necessitates lowering tidal volume (VT). Intubated patients in the surgical intensive care unit (SICU) were randomly assigned to group 1 (VT = 12 ml/kg, n = 56) or group 2 (VT = 6 ml/kg, n = 47). Variables recorded included acute physiology and chronic health evaluation (APACHE II) score, mean peak airway pressure (MPAP), mean PaO2/FIO2, incidence of pulmonary infectious complications (PIC), duration of intubation (DOI), and duration of SICU stay (DOS). The incidence of pulmonary infection tended to be lower and DOI and DOS tended to be shorter for nonneurosurgical and noncardiac surgical patients randomized to low VT, suggesting that morbidity may be decreased. The use of low VT was associated with a statistically significant but clinically irrelevant decrease in oxygenation. The routine use of low VT appeared to be safe in a selected population of patients in the SICU.
AB - High airway pressure may be injurious to lung parenchyma, but lowering airway pressure using conventional mechanical ventilation necessitates lowering tidal volume (VT). Intubated patients in the surgical intensive care unit (SICU) were randomly assigned to group 1 (VT = 12 ml/kg, n = 56) or group 2 (VT = 6 ml/kg, n = 47). Variables recorded included acute physiology and chronic health evaluation (APACHE II) score, mean peak airway pressure (MPAP), mean PaO2/FIO2, incidence of pulmonary infectious complications (PIC), duration of intubation (DOI), and duration of SICU stay (DOS). The incidence of pulmonary infection tended to be lower and DOI and DOS tended to be shorter for nonneurosurgical and noncardiac surgical patients randomized to low VT, suggesting that morbidity may be decreased. The use of low VT was associated with a statistically significant but clinically irrelevant decrease in oxygenation. The routine use of low VT appeared to be safe in a selected population of patients in the SICU.
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U2 - 10.1378/chest.97.2.430
DO - 10.1378/chest.97.2.430
M3 - Article
C2 - 2288551
AN - SCOPUS:0025124332
VL - 97
SP - 430
EP - 434
JO - Diseases of the chest
JF - Diseases of the chest
SN - 0012-3692
IS - 2
ER -