9 / 100
I
t
is
impossible
to
know
the
way
if
we
do
not
know
where
to
start
:
tidal
volume
,
driving
pressure
,
and
positive
end
-
expiratory
pressure
R
ev
A
ssoc
M
ed
B
ras
2017; 63(1):1-3
3
Mechanical ventilation in ARDS remains a major
challenge for intensive care physicians, but newly aggre-
gated knowledge and the new technologies available open
a new perspective on the path that will still be pursued.
R
eferences
1. Ochiai R. Mechanical ventilation of acute respiratory distress syndrome. J
Intensive Care. 2015; 3(1):25.
2. Gattinoni L, Pesenti A, Avalli L, Rossi F, Bombino M. Pressure-volume curve
of total respiratory system in acute respiratory failure. Computed
tomographic scan study. Am Rev Respir Dis. 1987; 136(3):730-6.
3. Gattinoni L, D’Andrea L, Pelosi P, Vitale G, Pesenti A, Fumagalli R. Regional
effects and mechanism of positive end-expiratory pressure in early adult
respiratory distress syndrome. JAMA. 1993; 269(16):2122-7.
4.
Petty TL, Ashbaugh DG. The adult respiratory distress syndrome. Clinical
features, factors influencing prognosis and principles of management. Chest.
1971; 60(3):233-9.
5. Tremblay LN, Slutsky AS. Ventilator-induced lung injury: from the bench
to the bedside. Intensive Care Med. 2006; 32(1):24-33.
6. Tremblay L, Valenza F, Ribeiro SP, Li J, Slutsky AS. Injurious ventilatory
strategies increase cytokines and c-fos m-RNA expression in an isolated rat
lung model. J Clin Invest. 1997; 99(5):944-52.
7.
Imai Y, Parodo J, Kajikawa O, de Perrot M, Fischer S, Edwards V, et al.
Injurious mechanical ventilation and end-organ epithelial cell apoptosis
and organ dysfunction in an experimental model of acute respiratory distress
syndrome.. JAMA. 2003; 289(16):2104-12.
8.
Slutsky AS, Ranieri VM. Ventilator-induced lung injury. N Engl J Med. 2013;
369(22):2126-36.
9.
Kotur P. Mechanical ventilation – Past, present and future. Indian J Anaesth.
2004; 48(6):430-2.
10.
Slutsky AS. History of mechanical ventilation. From Vesalius to ventilator-
induced lung injury. Am J Respir Crit Care Med. 2015; 191(10):1106-15.
11.
Petrucci N, Iacovelli W. Lung protective ventilation strategy for the acute
respiratory distress syndrome. Cochrane Database Syst Rev. 2007;
(3):CD003844.
12.
Petrucci N, De Feo C. Lung protective ventilation strategy for the acute
respiratory distress syndrome. Cochrane Database Syst Rev. 2013;
(2):CD003844.
13. Amato MB, Barbas CS, Medeiros DM, Magaldi RB, Schettino GP, Lorenzi-
Filho G, et al. Effect of a protective-ventilation strategy on mortality in the
acute respiratory distress syndrome. N Engl J Med. 1998; 338(6):347-54.
14. Ventilation with lower tidal volumes as compared with traditional tidal
volumes for acute lung injury and the acute respiratory distress syndrome.
The Acute Respiratory Distress Syndrome Network. N Engl J Med. 2000;
342(18):1301-8.
15.
Brochard L, Roudot-Thoraval F, Roupie E, Delclaux C, Chastre J, Fernandez-
Mondéjar E, et al. Tidal volume reduction for prevention of ventilator-
induced lung injury in acute respiratory distress syndrome. The Multicenter
Trail Group on Tidal Volume reduction in ARDS. Am J Respir Crit Care
Med. 1998; 158(6):1831-8.
16.
Brower RG, Shanholtz CB, Fessler HE, Shade DM, White P Jr, Wiener CM,
et al. Prospective, randomized, controlled clinical trial comparing traditional
versus reduced tidal volume ventilation in acute respiratory distress syndrome
patients. Crit Care Med. 1999; 27(8):1492-8.
17.
Stewart TE, Meade MO, Cook DJ, Granton JT, Hodder RV, Lapinsky SE, et
al. Evaluation of a ventilation strategy to prevent barotrauma in patients
at high risk for acute respiratory distress syndrome. Pressure- and Volume-
Limited Ventilation Strategy Group. N Engl J Med. 1998; 338(6):355-61.
18. Villar J, Kacmarek RM, Pérez-Méndez L, Aguirre-Jaime A. A high positive
end-expiratory pressure, low tidal volume ventilatory strategy improves
outcome in persistent acute respiratory distress syndrome: a randomized,
controlled trial. Crit Care Med. 2006; 34(5):1311-8.
19. Amato MB, Meade MO, Slutsky AS, Brochard L, Costa EL, Schoenfeld DA,
et al. Driving pressure and survival in the acute respiratory distress syndrome.
N Engl J Med. 2015; 372(8):747-55.
20. Ventilation with lower tidal volumes as compared with traditional tidal
volumes for acute lung injury and the acute respiratory distress syndrome.
The Acute Respiratory Distress Syndrome Network. N Engl J Med. 2000;
342(18):1301-8.
21. Brower RG, Lanken PN, MacIntyre N, Matthay MA, Morris A, Ancukiewicz M,
et al.; National Heart, Lung, and Blood Institute ARDS Clinical Trials Network.
Higher versus lower positive end-expiratory pressures in patients with the acute
respiratory distress syndrome. N Engl J Med. 2004; 351(4):327-36.
22.
Meade MO, Cook DJ, Guyatt GH, Slutsky AS, Arabi YM, Cooper DJ, et al.;
Lung Open Ventilation Study Investigators. Ventilation strategy using low
tidal volumes, recruitment maneuvers, and high positive end-expiratory
pressure for acute lung injury. JAMA. 2008; 299(6):637-45.
23.
Mercat A, Richard JC, Vielle B, Jaber S, Osman D, Diehl JL, et al.; Expiratory
Pressure (Express) Study Group. Positive end-expiratory pressure setting in
adults with acute lung injury and acute respiratory distress syndrome: a
randomized controlled trial. JAMA. 2008; 299(6):646-55.
24. Grasso S, Fanelli V, Cafarelli A, Anaclerio R, Amabile M, Ancona G, et al. Effects
of high versus low positive end-expiratory pressures in acute respiratory
distress syndrome. Am J Respir Crit Care Med. 2005; 171(9):1002-8.
25. Gattinoni L, Tonetti T, Cressoni M, Cadringher P, Herrmann P, Moerer O,
et al. Ventilator-related causes of lung injury: the mechanical power. Intensive
Care Med. 2016; 42(10):1567-75.
26.
de Carvalho WB, Fonseca MC, Johnston C. Electric impedance tomography,
the final frontier is close: the bedside reality. Crit Care Med. 2007;
35(8):1996-7.