PulmPEEPs 77. RFJC 9 – ARDS Series – ARMA
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Jul 23, 2024 Dive into the complexities of Acute Respiratory Distress Syndrome (ARDS) as this discussion launches a summer series on landmark trials. Explore the impactful ARMA trial, which revolutionized ventilation strategies in ARDS care by comparing traditional and lower tidal volumes. Discover how participant selection and trial methodologies shape critical outcomes like mortality and vent-free days. The episode emphasizes lung-protective ventilation practices, the evolution of pulmonary care, and the implications for personalized treatment approaches.
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ARMA Trial Changed ARDS Ventilation
- The ARMA trial compared ventilation strategies in ARDS, fundamentally changing standard care.
- It established lower tidal volumes and plateau pressures significantly improve outcomes.
Tidal Volume Strategies Compared
- The trial compared high tidal volumes (
12 cc/kg) against low volumes (6 cc/kg) with plateau pressures of 30 or less. - Both groups used similar PEEP and oxygenation targets to isolate tidal volume effects.
Positive Outcomes With Low Tidal Volumes
- Lower tidal volume ventilation reduced mortality from ~40% to 31% and increased ventilator-free days.
- The number needed to treat was just over 11, showing a strong benefit for lung protective ventilation.