ART
2017 Respiratory
120 ICUs
1013 patients
Clinical Question
In patients with moderate to severe acute respiratory distress syndrome
(ARDS) does use of a lung recruitment maneuver associated with positive
end-expiratory pressure (PEEP) titration according to the best
respiratory-system compliance, compared with a conventional low-PEEP
strategy, decrease 28-day mortality?
Critical Appraisal
Critique
Blinding not possible. High mortality in both arms.
- Population
- ARDS
- Population Details
- PaO2/FiO2 < 200
- Intervention Arms
-
Recruitment maneuvers + open lung ventilation (n=501)
PEEP 25 (1min), then 35 (1min), then 45 cmH2O for 2 minutes - Control Arms
-
ARDSnet protocol (n=509)
- Primary Outcome
- 28 day mortality
- Secondary Outcomes
- 6 month mortality Increase in barotrauma
- P Value
- 0.04
Outcome Results
Not recorded
Primary location: Brazil
Other locations: Argentine Republic
Landmark trial