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Ventilation in the ED: Attention must be paid

      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

        • Putensen C
        • Theuerkauf N
        • Zinserling J
        • Wrigge H
        • Pelosi P
        Meta-analysis: ventilation strategies and outcomes of the acute respiratory distress syndrome and acute lung injury.
        Ann Intern Med. 2009; 151: 566-576
        • Neto AS
        • Cardoso SO
        • Manetta JA
        • Pereira VGM
        • Esposito DC
        • Pasqualucci Mde O
        • et al.
        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
        • Dreyfuss D
        • Saumon G
        Ventilator-induced lung injury: lessons from experimental studies.
        Am J Respir Crit Care Med. 1998; 157: 294-323
        • Hillman NH
        • Moss TJM
        • Kallapur SG
        • Bachurski C
        • Pillow JJ
        • Polglase GR
        • et al.
        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
        • Futier E
        • Constantin J-M
        • Paugam-Burtz C
        • Pascal J
        • Eurin M
        • Neuschwander A
        • et al.
        A trial of intraoperative low-tidal-volume ventilation in abdominal surgery.
        N Engl J Med. 2013; 369: 428-437