Is acute respiratory distress syndrome an iatrogenic disease?

被引:41
作者
Villar, Jesus [1 ,2 ,3 ]
Slutsky, Arthur S. [1 ,4 ,5 ]
机构
[1] St Michaels Hosp, Keenan Res Ctr, Li Ka Shing Knowledge Inst, Toronto, ON M5B 1W8, Canada
[2] Inst Salud Carlos III, CIBER Enfermedades Resp, Madrid, Spain
[3] Hosp Univ Dr Negrin, Multidisciplinary Organ Dysfunct Evaluat Res Netw, Res Unit, Las Palmas Gran Canaria, Spain
[4] Univ Toronto, Interdepartmental Div Crit Care Med, Toronto, ON, Canada
[5] King Saud Univ, Riyadh, Saudi Arabia
来源
CRITICAL CARE | 2010年 / 14卷 / 01期
关键词
ACUTE LUNG INJURY; END-EXPIRATORY PRESSURE; TIDAL VOLUMES; MECHANICAL VENTILATION; PULMONARY-EDEMA; TRIALS;
D O I
10.1186/cc8842
中图分类号
R4 [临床医学];
学科分类号
1002 ; 100602 ;
摘要
In this month's issue of Critical Care, Determann and colleagues report the results of a randomized controlled trial comparing the effects of mechanical ventilation (MV) with two tidal volumes (6 versus 10 ml/kg predicted body weight) on cytokine levels in lung lavage fluid and plasma as a surrogate for early identification of acute lung injury (ALI) and/or acute respiratory distress syndrome (ARDS). The study was stopped early after an interim analysis when 150 patients were enrolled - showing that the incidence of ALI/ARDS according to the current definition was 10.9% higher in the 10 ml/kg group, although duration of MV and mortality was similar in both groups. We examine these interesting results after providing a brief historical perspective and discuss the limitations and implications of the study.
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页数:3
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