| Design | Multicentre randomised trial, stopped early for efficacy |
|---|---|
| Treatment | Tidal volume 6 mL/kg predicted body weight |
| Control | Traditional tidal volume of 12 mL/kg predicted body weight |
| Population | 861 patients with acute lung injury and ARDS |
| Follow-up | 180 days |
| Primary endpoint | Death before discharge home and breathing without assistance |
| Result | Mortality 31.0% with lower tidal volumes versus 39.8% with traditional volumes (p=0.007). Ventilator-free days in the first 28 days 12 versus 10 (p=0.007). Achieved tidal volumes on days 1 to 3 were 6.2 and 11.8 mL/kg predicted body weight. The trial was stopped early. |
| Secondary endpoints | Ventilator-free days, organ failure-free days |
In patients with acute lung injury and the acute respiratory distress syndrome, mechanical ventilation with a lower tidal volume than is traditionally used results in decreased mortality and increases the number of days without ventilator use.
The trial authors, in the published abstract
Still the single most important intervention in ARDS, and an absolute mortality reduction of nearly 9 percentage points that no subsequent drug has approached. Everything after it — PROSEVA, ACURASYS, EOLIA — is tested on top of lung-protective ventilation, not instead of it.
Brower RG, Matthay MA, Morris A, et al. Ventilation with lower tidal volumes as compared with traditional tidal volumes for acute lung injury and the acute respiratory distress syndrome. N Engl J Med 2000 May 4;342(18):1301-8.