Reducing Mortality in Critically Ill Patients | 2021
Mechanical Ventilation in ARDS
Abstract
Lung-protective ventilation (LPV) and prone positioning (PP) are currently the two cornerstones of acute respiratory distress syndrome (ARDS) treatment. LPV with low tidal volumes, moderate-to-high levels of positive end-expiratory pressure (PEEP) and, possibly, recruitment maneuvers has been widely shown in randomized controlled trials (RCTs) to reduce mortality in ARDS patients. However, evidence about the favorable effects in terms of survival of PEEP and recruitment maneuvers is not as conclusive as that about low tidal volumes. PP has been shown for over 40 years to improve oxygenation in ARDS patients but only in recent years a large multicenter RCT succeeded in showing improved survival with this strategy.