Ultra-protective tidal volume: how low should we go?
1 Cardio-Pulmonary Department, Pulmonary Division, Hospital das Clínicas, University of São Paulo, Av. Dr. Arnaldo 455, sala 2144 (2nd floor), São Paulo, SP, Brazil. CEP: 01246-903
2 Research and Education Institute of Hospital Sírio Libanês in São Paulo, R Cel Nicolau dos Santos, 69, São Paulo, Brazil. CEP: 01308-60
Critical Care 2013, 17:127 doi:10.1186/cc12556
See related research by Retamal et al., http://ccforum.com/content/17/1/R16Published: 28 March 2013
Applying tidal volumes of less than 6 mL/kg might improve lung protection in patients with acute respiratory distress syndrome. In a recent article, Retamal and colleagues showed that such a reduction is feasible with conventional mechanical ventilation and leads to less tidal recruitment and overdistension without causing carbon dioxide retention or auto-positive end-expiratory pressure. However, whether the compensatory increase in the respiratory rate blunts the lung protection remains unestablished.