Spontaneous Versus Controlled Mechanical Ventilation in Patients with Acute Respiratory Distress Syndrome.
Curr Anesthesiol Rep
; 11(2): 85-91, 2021.
Article
in English
| MEDLINE | ID: covidwho-1474172
ABSTRACT
PURPOSE OF REVIEW To review clinical evidence on whether or not to allow mechanically ventilated patients with acute respiratory distress syndrome (ARDS) to breathe spontaneously. RECENT FINDINGS:
Observational data (LUNG SAFE study) indicate that mechanical ventilation allowing for spontaneous breathing (SB) is associated with more ventilator-free days and a shorter stay in the intensive care unit without any effect on hospital mortality. A paediatric trial, comparing airway pressure release ventilation (APRV) and low-tidal volume ventilation, showed an increase in mortality in the APRV group. Conversely, in an unpublished trial comparing SB and controlled ventilation (NCT01862016), the authors concluded that SB is feasible but did not improve outcomes in ARDS patients.SUMMARY:
A paucity of clinical trial data continues to prevent firm guidance on if or when to allow SB during mechanical ventilation in patients with ARDS. No published large randomised controlled trial exists to inform practice about the benefits and harms of either mode.
Full text:
Available
Collection:
International databases
Database:
MEDLINE
Type of study:
Experimental Studies
/
Observational study
/
Prognostic study
/
Randomized controlled trials
Language:
English
Journal:
Curr Anesthesiol Rep
Year:
2021
Document Type:
Article
Affiliation country:
S40140-021-00443-8
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