{"id":24617,"date":"2023-11-14T04:32:00","date_gmt":"2023-11-13T20:32:00","guid":{"rendered":"http:\/\/csccm.org.cn\/?p=24617"},"modified":"2023-11-14T05:48:15","modified_gmt":"2023-11-13T21:48:15","slug":"icu-management-practice-%e6%96%b0%e5%86%a0%e7%97%85%e6%af%92%e6%84%9f%e6%9f%93%e7%9b%b8%e5%85%b3ards%e7%9a%84%e8%b6%85%e4%bd%8e%e6%bd%ae%e6%b0%94%e9%87%8f%e9%80%9a%e6%b0%94","status":"publish","type":"post","link":"https:\/\/csccm.org.cn\/?p=24617","title":{"rendered":"[ICU Management & Practice]: \u65b0\u51a0\u75c5\u6bd2\u611f\u67d3\u76f8\u5173ARDS\u7684\u8d85\u4f4e\u6f6e\u6c14\u91cf\u901a\u6c14"},"content":{"rendered":"\n

Ultra-Low Tidal Volume Ventilation for COVID-19-ARDS<\/h1>\n\n\n\n
\"\"\/<\/figure>\n\n\n\n

A new study aimed to evaluate the effectiveness of ventilation with ultra-low tidal volume (ULTV) compared to low tidal volume (LTV) in patients suffering from COVID-19-related acute respiratory distress syndrome (ARDS). COVID-19-related ARDS is associated with a high mortality rate and extended mechanical ventilation duration. <\/p>\n\n\n\n

The study was conducted in ten ICUs in France and included patients who were 18 years or older, required invasive mechanical ventilation for COVID-19, had ARDS, a partial pressure of arterial oxygen to inspiratory oxygen fraction (PaO2\/FiO2) ratio of 150 mm Hg or less, a tidal volume (VT) of 6.0 mL\/kg predicted body weight or less, and received continuous intravenous sedation.<\/p>\n\n\n\n

Study patients were randomly assigned in a 1:1 ratio to receive either ULTV with a target VT of 4.0 mL\/kg predicted body weight (intervention group) or LTV with a target VT of 6.0 mL\/kg predicted body weight (control group). The primary outcome was all-cause mortality at day 90 and the number of ventilator-free days among patients alive at day 60. <\/p>\n\n\n\n

A total of 215 patients were included in the study. 27% were female, and 73% were male, with a median age of 68 years. One hundred and six patients were assigned to the ULTV group, and 109 were assigned to the LTV group. <\/p>\n\n\n\n

As per the findings, the primary outcome did not show a significant difference between the ULTV and LTV groups. By day 90, 44% of 105 patients in the ULTV group and 39% of 109 patients in the LTV group had died. However, the ULTV group had a higher rate of severe respiratory acidosis within the first 28 days than the LTV group. <\/p>\n\n\n\n

The study found that among patients with moderate-to-severe COVID-19-related ARDS, there was no significant difference between ULTV and LTV ventilation strategies based on mortality and ventilator-free days among patients alive at day 60. Hence, these results do not support the routine use of ULTV in patients with COVID-19-related ARDS.<\/p>\n\n\n\n

Source: The Lancet Respiratory Medicine<\/a><\/p>\n\n\n\n

Image Credit: iStock <\/p>\n\n\n\n

\u00ab\u00ab Tranexamic Acid for Intracerebral Haemorrhage in Patients on NOAC <\/a><\/p>\n\n\n\n

Intraoperative Oxygen Administration in OPCAB \u00bb\u00bb<\/a><\/p>\n\n\n\n

References:<\/h4>\n\n\n\n

Richard J-C, Terzi N, Yonis H et al. (2023) Ultra-low tidal volume ventilation for COVID-19-related ARDS in France (VT4COVID): a multicentre, open-label, parallel-group, randomised trial.<\/a> The Lancet Respiratory Medicine.<\/p>\n\n\n\n

Published on : Tue, 18 Jul 2023<\/p>\n","protected":false},"excerpt":{"rendered":"

Ultra-Low Tidal Volume Ventilation for COVID-19-ARDS A […]<\/p>\n","protected":false},"author":3,"featured_media":0,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":[],"categories":[24,23],"tags":[],"_links":{"self":[{"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/posts\/24617"}],"collection":[{"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/users\/3"}],"replies":[{"embeddable":true,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=%2Fwp%2Fv2%2Fcomments&post=24617"}],"version-history":[{"count":1,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/posts\/24617\/revisions"}],"predecessor-version":[{"id":24618,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/posts\/24617\/revisions\/24618"}],"wp:attachment":[{"href":"https:\/\/csccm.org.cn\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=24617"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=%2Fwp%2Fv2%2Fcategories&post=24617"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=%2Fwp%2Fv2%2Ftags&post=24617"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}