Chest
Clinical Investigations in Critical CareProspective Randomized Trial Comparing Pressure-Controlled Ventilation and Volume-Controlled Ventilation in ARDS
Section snippets
Patients
From February 1995 to January 1996, we enrolled patients at 12 ICUs in 12 tertiary-care hospitals. The study was approved by the institutional review board of each medical center, and informed consent was obtained from each patient or the patient's next of kin. The criteria for enrollment were as follows: (1) one or more underlying disease processes that are known to be associated with ARDS (sepsis, shock, pneumonia, multiple transfusions, pulmonary contusion, multiple fractures, gastric
Results
Seventy-nine patients with ARDS were enrolled in the study, 42 in the VCV group and 37 in the PCV group. There were no significant differences between the studied groups regarding clinical characteristics and risk factors for ARDS at the moment of randomization (Tables 1, 2), although a trend toward a higher rate of acute renal failure was observed in patients of the VCV group (Table 1), and there was also a tendency toward a higher percentage of patients with shock as a risk factor for ARDS in
Discussion
The main finding of this study was that, in patients with ARDS who require mechanical ventilation, the way in which mechanical ventilation is provided to deliberately reduce the inspiratory plateau pressure, by decreasing either Vt on VCV or inspiratory pressure on PCV, does not independently influence mortality. We also have found that the mortality of ARDS patients is strongly associated with the development of multiple organ failure, with especially those patients with acute renal failure
Appendix
Members of the Spanish Lung Failure Collaborative Group are: Juan A. Gomez-Rubí, MD, PhD (Hospital Virgen de la Arrixaca, Murcia); Santiago Macías, MD (Hospital General de Segovia, Segovia); Ana I. Ezpeleta, MD, PhD (Hospital General de Alicante, Alicante); Anselmo Gil, MD (Hospital del S.A.S., Jerez de la Frontera); Alfonso Bonet, MD (Hospital Dr. Josep Trueta, Girona); Demetrio Carriedo, MD (Hospital Virgen Blanca, León); José M. Allegue, MD (Hospital Nuestra Señora del Rosell, Cartagena);
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2019, Critical Care Nephrology: Third Edition
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A complete list of the members of the Spanish Lung Failure Collaborative Group is located in the Appendix.