PHARLAP

2019 Respiratory
? ICUs
113 patients

Clinical Question

Does an open lung ventilation strategy which includes maximal recruitment maneuvers (RMs) and positive end-expiratory pressure (PEEP) titration improve outcomes compared to traditional lung-protective ventilation in patients with moderate – severe acute respiratory distress syndrome (ARDS)?

Critical Appraisal

Critique

Stopped early due to results of the ART trial

Population
ARDS
Population Details
Severe ARDS
Intervention Arms

Open lung ventilation with recruitment maneuvres
Staircase RMs - 20 -> 30 -> 40 cmH2O. Stepwise PEEP titration, min 15 cmH2O

Control Arms

Recruitment manoeuvres not permitted

Primary Outcome
Ventilator free days at day 28
Secondary Outcomes
No difference in mortality , No difference in any secondary outcome
P Value
0.95

Outcome Results

Not recorded