Is acute respiratory distress syndrome an iatrogenic disease?
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.
Jesús
J
Villar
Arthur S
AS
Slutsky
D001992:Bronchoalveolar Lavage Fluid; D016207:Cytokines / Q000097:blood / Q000378:metabolism; D006801:Humans; D007049:Iatrogenic Disease; D012121:Respiration, Artificial / Q000009:adverse effects; D012128:Respiratory Distress Syndrome / Q000209:etiology* / Q000378:metabolism
D016207:Cytokines