The @entity649 ( @entity649 ) Network study found 22% lower mortality in @entity647 and @entity649 @entity1 ventilated with low tidal volumes (V(T)) than in those ventilated with traditional V(T) ventilation. Several points should be considered when using the low V(T) protocol for clinical practice. Prior to implementation, hemodynamic and acid-base status, minute ventilation, and adequacy of sedation should be assessed to minimize the potential for intolerance. The volume-preset, assist-control mode is recommended for better control of V(T), and the respiratory rate should be increased as V(T) is reduced, so as to maintain minute ventilation and prevent acute @entity2944 . When unavoidable, @entity2944 should be induced slowly. Ventilator inspiratory flow (V(I)) and trigger sensitivity settings should be optimized to limit the @entity1353 . When @entity1353 results in double-triggered breaths, V(T) can be titrated to 7-8 mL/kg, provided end-inspiratory plateau pressure is < or = 30 cm @entity2507 . In severe @entity520 (pH < 7.15) V(T) also can be increased. However, every effort should be made to maintain plateau pressure and V(T) goals by buffering severe @entity520 and treating @entity1 -ventilator asynchrony with sedation. Evaluation for weaning should occur when adequate oxygenation can be maintained on 40% @entity26 and a positive end-expiratory pressure of 8 cm @entity2507 . Pressure support levels between 5 and 20 cm @entity2507 (above 5 cm @entity2507 positive end-expiratory pressure) are used for weaning and titrated to keep the respiratory rate < 35 breaths/min. Pressure support levels should be weaned aggressively, as long as the protocol's weaning tolerance criteria can be maintained.

Implementation of a low tidal volume ventilation protocol for @entity1 with @entity647 or XXXX .

@entity1 :: ('9606', 'Species') :: ['patients', 'patient'] @entity2944 :: ('MESH:D006935', 'Disease') :: ['hypercapnia'] @entity1353 :: ('MESH:D004417', 'Disease') :: ['increase in work of breathing and dyspnea', 'dyspnea'] @entity649 :: ('MESH:D012128', 'Disease') :: ['ARDS', 'acute respiratory distress syndrome'] @entity26 :: ('MESH:D010100', 'Chemical') :: ['oxygen'] @entity520 :: ('MESH:D000138', 'Disease') :: ['acidosis'] @entity2507 :: ('CHEBI:33813', 'Chemical') :: ['H(2)O'] @entity647 :: ('MESH:D055371', 'Disease') :: ['acute lung injury']
@entity649 :: (MESH:D012128,Disease) :: ['acute respiratory distress syndrome']
