Intervention
Population
Conclusion

RCT: ARMA

ARDSNet
NEJM (2000)

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  • Low Tidal volume ventilation (6ml/kg PBW) vs standard care (12mL/kg PBW)
  • 861 patients with ARDS (P/F ratio <39kPa)
  • Lower tidal volume group demonstrated:
    • Significantly reduced mortality (31% vs 39.8%, p=0.007)
    • Significantly increased ventilator-free (12 vs. 10 p=0.007)
    The Bottom Line Review

Meta-Analysis

Walkley et al
Annals ATS (2017)

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  • Ventilation strategies that limit tidal volumes and inspiratory pressures vs. strategies with tidal volumes of 10 to 15 ml/kg
  • 7 randomized controlled trials involving 1,481 patients with ARDS
  • Non-significant trend towards lower mortality with low tidal volume relative risk (RR 0.87; 95% confidence interval 0.70-1.08) heterogeneity statistic
  • Significant relationship between the degree of tidal volume reduction and the mortality effect