Journal Club - Recent Additions

February - 2015

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Showing Journal 3 of 10

Driving Pressure and Survival in the Acute Respiratory Distress Syndrome

M Amato, M O’Meade, A Slutsky, L Brochard, et al NEJM, 2015, 372:747-755

Comment

This special article is authored by a pool of experts in ARDS, so is definitely worth considering.

The components of a protective lung strategy, aimed at reducing ventilator induced mechanical stress, include;

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February

Paper

Readers Comments - 1

Previous Comments

I found this hard to read, but very interesting. The "sweet spot" for delta P is (buried in the supplimental material, probably under 12cmH2o. I found it interesting that the peak pressure was almost completely unassociated with mortality in ARDS, where that high peak was due to high PEEP and a small deltaP, while when the converse occured there was a strong association. The method of hypothesis generating in one dataset, then testing across a second set makes this much more robust than a conventional retrospective data trawl. Overall, a paper which at least warrants thought.. and perhaps a change in practice while we await definitive trials.
matbailey-24 Feb, 2015 06:45:58 AM