Author Question: What conclusion has been drawn regarding the use HFOV in terms of limiting the development of VILI? ... (Read 13 times)

APUS57 · **on:** Jul 16, 2018

What conclusion has been drawn regarding the use HFOV in terms of limiting the development of VILI?

A. HFOV is useful in limiting VILI in patients with ALI.
B. HFOV is useful in limiting VILI in patients with ALI when low FIO2s are used.
C. HFOV is useful in limiting VILI in patients with ALI when high FIO2s are used.
D. The data did not detect any difference between HFOV and conventional, low-VT ventilation in limiting VILI in patients with ALI.

Question 2

What conclusions were drawn from the Acute Respiratory Distress Syndrome Network (ARDSnet) study regarding ventilator-induced lung injury?

A. The tidal volume used to ventilate a patient is not as important as the pressure delivered to the lungs.
B. Low tidal volume ventilation attenuates ventilator-induced lung injury (VILI).
C. Plateau pressure levels are the most important consideration in preventing VILI.
D. PEEP levels used in conjunction with mechanical ventilation are the most important consideration in minimizing VILI?

kswal303 · **Reply #1 on:** Jul 16, 2018

Answer to Question 1

ANS: D
A. Incorrect response: See explanation D.
B. Incorrect response: See explanation D.
C. Incorrect response: See explanation D.
D. Correct response: The trial conducted to determine if HFOV might be a modality to limit VILI in patients with ALI was underpowered. The comparison of HFOV and conventional, low-VT ventilation (6-10 ml/kg actual body weight; mean 8 ml/kg) proved inconclusive, and further randomized trials are needed.

Answer to Question 2

ANS: B
A. Incorrect response: See explanation B.
B. Correct response: When the ARDSnet study was terminated, mortality was reduced from 40 to 31 with low tidal volume intervention. Patients receiving lower tidal volumes had significantly more ventilator-free days. The ARDSnet trial clearly established the benefits of using low tidal volumes to ventilate patients with ALI and presented compelling evidence in humans for VILI.
C. Incorrect response: See explanation B.
D. Incorrect response: See explanation B.