Spontaneous Versus Controlled Mechanical Ventilation in Patients with Acute Respiratory Distress Syndrome

Tayyba Naz Aslam, Thomas Lass Klitgaard, Kristin Hofsø, Bodil Steen Rasmussen, Jon Henrik Laake

Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

Abstrakt

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 Conversely, in an unpublished trial comparing SB and controlled ventilation (NCT01862016), the authors concluded that SB is feasible but did not improve outcomes in ARDS patients.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.

OriginalsprogEngelsk
TidsskriftCurrent Anesthesiology Reports
Antal sider7
ISSN2167-6275
DOI
StatusE-pub ahead of print - 3 mar. 2021

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