|
|
 |
Author |
Post |
|
|
|
| |
User Comment
|
Prevent Excessive Inspiratory Plateau Pressures
2/17/2005 9:15:18 PM
User Comments on Prevent Excessive Inspiratory Plateau Pressures
|
|
|
|
|
|
| |
Total Posts: 3
|
Re: Prevent Excessive Inspiratory Plateau Pressures
1/29/2006 12:42:41 PM
I have two comments:
The ARDSnet link provided on this page does not appear to work.
The primary hypothesis of the ARDSnet paper was comparing 6 ml/kg IBW tidal volume to 12 m/kg IBW tidal volume. This point is certainly not emphased in the bundle. Maintaining plateau pressure less than 30 was a secondary strategy which allowed clinicians to use even lower tidal volumes. It was never a reason to use higher tidal volumes. I am concerned that the way the bundle is worded clinicians will feel comfortable using the largest tidal volume that allows a plateau pressure less than 30. I don't believe that strategy would fit the ARDSnet model.
In ARDSnet the benefit was not one of less barotrauma in the low tidal volume group as one might expect from limiting Ppl but rather it was a reduction in secondary organ failures presumably mediated by the documented lower incidence of inflammatory mediators caused by less lung stretch.
Fil Ferrigni, MD, FCCM
|
|
|
|
|
