ARMA Study Synopsis
Prospective, Randomized, Multi-Center Trial of 12ml/kg Tidal Volume Positive Pressure Ventilation for Treatment of Acute Lung Injury and Acute Respiratory Distress Syndrome (ARMA)
This landmark third trial examined lower tidal volume ventilation versus a traditionally recommended larger tidal volume approach in patients with acute lung injury . This trial was undertaken because extensive animal studies and two small clinical trials suggested lung stretch with larger tidal volumes may injure the lung or prevent recovery. However, two other clinical trials raised questions about this hypothesis and the use of smaller tidal volumes is not always easy to do. This randomized controlled trial, which enrolled 861 subjects, answered this question clearly showing for the first time that lower tidal volumes result in improved survival, with a similar need for sedatives for patient comfort. This study was published in the New England Journal of Medicine in May 2000 and has catalyzed major changes in the approach to mecahnical ventilation for patients with ARDS workldwide (The Acute Respiratory Distress Syndrome Network. Ventilation with lower tidal volumes as compared with traditional tidal volumes for acute lung injury and the acute respiratory distress syndrome. N Engl J Med. 2000;342:1301-1308).