A study appearing in JAMA suggests that in patients without acute respiratory distress syndrome (ARDS) the use of protective mechanical ventilation with lower tidal volumes was linked to improved patient outcomes. These outcomes reportedly included less lung injury, lower mortality, fewer pulmonary infections, and a shorter hospital stays.
During the study, Ary Serpa Neto, MD, MSc, from the ABC Medical School, located in Santo Andre, Sao Paulo, Brazil, and colleagues used meta-analysis to pinpoint whether conventional or protective tidal volumes would be linked to lung injury, mortality, and pulmonary infection in patients without lung injury at the onset of mechanical ventilation.
The results indicated a 67% decreased risk of lung injury development and a 36% decrease in the risk of death in patients receiving ventilation with lower tidal volumes. Researchers report that the results of lung injury development were similar when stratified by the type of study, randomized versus nonrandomized, and exhibited significance only in randomized trials for pulmonary infection and lower average hospital length of stay.
The authors reiterate the study’s findings, noting that the meta-analysis, “suggests that among patients without lung injury, protective ventilation with use of lower tidal volumes at onset of mechanical ventilation may be linked to better clinical outcomes.”
The authors add that clinical trials are necessary in order to compare higher and lower tidal volumes in a heterogeneous group of patients receiving mechanical ventilation for longer periods.