Tidal Volume Lower than 6 ml/kg Enhances Lung Protection

Abstract

VT lower than 6 ml/Kg enhanced lung protection. Respiratory acidosis consequent to low VT ventilation was safely and efficiently managed by extracorporeal carbon dioxide removal.

Extracorporeal Gas Exchange for Acute Respiratory Failure in Adult Patients: A Systematic Review

“…In 10 patients with plateau pressure of 28-30 cmH 2 O at baseline, ECCO 2 R allowed a reduction of tidal volume (from 6 to 4 ml/kg) and of plateau pressure (from 29 to 25 cmH 2 O), while maintaining PaCO 2 around 50 mmHg [19]. This protective ventilation strategy was also associated with a significant reduction in proinflammatory cytokine levels in bronchoalveolar (BAL) fluid.…”

“…In addition, a proof-of-concept study suggested that the very low tidal volume ventilation (3.5-5 ml/kg of predicted body weight) permitted by ECCO 2 R can improve pulmonary protection and decrease pulmonary inflammation in ARDS patients [19] and a recent randomized trial suggested that this strategy may be associated with better outcomes for moderate to severe ARDS patients [11].…”

Will all ARDS patients be receiving mechanical ventilation in 2035? No

“…Mortality rates for a recent multicenter cohort of mild, moderate, and severe ARDS patients were 35, 40, and 46 %, respectively [1]. Although lowering the tidal volume also lowered mortality-despite initially worse oxygenation-we advance that the current protective MV strategies cannot sufficiently minimize VILI and foster lung healing [2].…”

Postoperative Pulmonary Complications: An Epidemiological, Risk Factors and Prevention Review

“…ECCO 2 R facilitates lung protective ventilation, allowing a greater reduction in VT [35]. In fact, researchers demonstrate the feasibility of combining ECCO 2 R with VT 3ml/kg and report that ventilation with very low tidal volumes is feasible, safe and easy to implement with this technique [35,40,41].…”