Prophylactic low tidal volume ventilation...?

• Previous message: "Ideal" Ventilator Parameters for Trauma Patients
• Next message: Prophylactic low tidal volume ventilation...?
• Messages sorted by: [ date ] [ thread ] [ subject ] [ author ]

Sorry - just processing a week's worth of email.

Annoyingly a lot of people are doing this and there is no evidence for it. ARDSNet ventilation is for ARDS and can be very harmful in other scenarios, for example a ventilated asthmatic [says he trying to think of something diametrically opposite to ARDS].

It's horses for courses and to unthinkingly adopt a ventilation strategy for anyone without thinking of risks and benefits is crazy. Has everyone forgotten Nunn's work back in the 1960s [which led to the adoption of sigh buttons on ventilators, to prevent unnecessary atelectasis]

And no, outside ALI/ARDS there is no evidence at all for adopting this sort of ventilation startegy.

Cheers, Ian

Ian Seppelt FANZCA FJFICM
Staff Specialist in Intensive Care Medicine
The Nepean Hospital, 
PO Box 63, Penrith NSW 2751
Clinical Lecturer, University of Sydney


>>> karim at trauma.org 09/16/05 05:32am >>>
I have been noticing an increasing trend for ICU being ventilated along an ARDSnet-type protocol (low tidal volume,
pressure-limited) even if they do not meet criteria for ARDS (or even ALI).  This is even part of the ventilator management
guidelines for the Phase 2B FVIIa trial.

As far as I am aware there is no evidence out there to support this, and there are significant drawbacks to such an unproven
strategy.  Have I missed any literature on this?  Is anyone else practicing this?  If so what's your rationale.

BTW - I think it would be a great study to do.

Karim

--
trauma-list : TRAUMA.ORG
To change your settings or unsubscribe visit:
http://www.trauma.org/traumalist.html

######################################################################
Attention: 
This message is intended for the addresses named and may contain 
confidential information. If you are not the intended recipient, please
delete it and notify the sender. Views expressed in this message are 
those of the individual sender, and are not necessarily the views of 
Sydney West Area Health Service.


This e-mail has been scanned for viruses
######################################################################

• Previous message: "Ideal" Ventilator Parameters for Trauma Patients
• Next message: Prophylactic low tidal volume ventilation...?
• Messages sorted by: [ date ] [ thread ] [ subject ] [ author ]