Lung-protective mechanical ventilation may be associated with a long-term survival benefit for patients with acute lung injury

摘要

Volume and pressure-limited ('lung-protective') mechanical ventilation decreases short-term mortality in patients with acute lung injury (ALI). This multicentre prospective cohort study from the USA evaluated the association of lung-protective mechanical ventilation with a 2-year survival period in patients with ALI. The study included 485 mechanically ventilated patients with ALI diagnosed according to the American-European Consensus criteria. After onset of ALI, twice-daily records of ventilator settings were measured yielding 6240 settings for evaluation. Those with tidal volumes <6.5 ml/kg and a plateau pressure <30 cm H_2O were deemed 'adherent' to lung-protective ventilation. In total, only 41% of ventilator settings recorded were adherent. Four hundred and seventeen patients (86%) received 50% or less of their ventilator-settings adherent, and 180 (37%) never received any settings adherent.