We would like to thank the authors for their letter to the editor regarding our observational
study of mechanical ventilation in the emergency department (ED), and we appreciate
their comments. The authors of the letter observe that our population was heterogeneous,
thereby limiting the ability to draw homogenous conclusions. We wholeheartedly agree,
and we noted in the Discussion that the lung protective and non-lung protective groups
were not evenly matched. As it was an observational study, we could not control for
all potentially confounding factors. Our univariate analyses demonstrated that receiving
lung protective ventilation was associated with increased mortality, and we suspected
that this may represent increased attention to the ventilator settings for higher
acuity patients with respiratory failure.
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References
- Meta-analysis: ventilation strategies and outcomes of the acute respiratory distress syndrome and acute lung injury.Ann Intern Med. 2009; 151: 566-576
- Association between use of lung-protective ventilation with lower tidal volumes and clinical outcomes among patients without acute respiratory distress syndrome.JAMA. 2012; 308: 1651-1659
- Ventilator-induced lung injury: lessons from experimental studies.Am J Respir Crit Care Med. 1998; 157: 294-323
- Brief, large tidal volume ventilation initiates lung injury and a systemic response in fetal sheep.Am J Respir Crit Care Med. 2007; 176: 575-581
- A trial of intraoperative low-tidal-volume ventilation in abdominal surgery.N Engl J Med. 2013; 369: 428-437
Article Info
Publication History
Published online: July 04, 2016
Accepted:
June 30,
2016
Received:
June 29,
2016
Footnotes
☆Sources of support: This letter was written at the affiliated institutions without grant support.
☆☆Prior presentations: This work has not been previously presented or published.
Identification
Copyright
© 2016 Elsevier Inc. All rights reserved.
