急性呼吸窮迫症候群の死亡率を下げるための肺開放換気 (LOVS)

Inclusion Criteria:

• Invasive mechanical ventilation
• Acute respiratory insufficiency (within past 28 days)
• Bilateral infiltrates on frontal chest radiograph
• Hypoxemia, defined as PaO2/FiO2<=250

Exclusion Criteria:

• Primary cause of respiratory failure is cardiac
• Anticipated duration of mechanical ventilation < 48 hours
• Inability to wean other experimental ventilation strategies
• Severe chronic respiratory disease
• Neuromuscular disease that will prolong mechanical ventilation
• Conditions where hypercapnia-induced intracranial hypertension should be avoided
• Morbid obesity (> 1Kg per cm body weight)
• Pregnancy
• Very unlikely to survive and lack of commitment to life support Underlying irreversible condition with 6 month mortality >= 50%
• Greater than 48 hours elapsed since first eligible
• Current participation in competing trial
• Lack of physician, patient or proxy consent