ACUTE RESPIRATORY DISTRESS SYNDROME (ARDS)

REDUCED TIDAL VOLUME VS TRADITIONAL TIDAL VOLUME

Abstract

Objectives: .To assess the safety, potential efficacy, morbidity and
mortality of a small tidal volume mechanical ventilation strategy designed to reduce stretch induced lung injury in ARDS.
Design: A prospective interventional experimental Setting: CMH Rawalpindi:..Period: .1st Sept 2001 to 30th June
2002. Material & Methods: ARDS is a disease associated with high rate of mortality. It was a prospective interventional
experimental study of 50 patients who underwent ventilatory support at intensive care unit of a tertiary care teaching
hospital Combined Military Hospital Rawalpindi. Results: In both the Traditional Tidal Volume(TTV) and Small Tidal
Volume (STV) groups 15 of 26 patients [58%] achieved Reversal of Respiratory Failure (RRF). Of the patients who
achieved RRF, the mean number of days on positive pressure ventilation were 11.9±1.9 and 11.3 ± 2.2 days for the
TV and STV patients respectively [not significant]. The mean number of days from the first day that weaning from MV
was allowed (when FI 02 was <or= 0.50 and PEEP was <or= 5) to RRF was 5.2 ±1.1 and 5.1 ±1.0 in the TTV and STV
groups respectively [p= .94] .Mortality before hospital discharge was 46% in the TTV group and 50 % in the STV group.
Conclusion The sample size was too small to discern small treatment effects. The differences in tidal volumes and
plateau pressures were modest or reduced tidal volume ventilation is not beneficial.