ARMA

Lower Tidal Volume Trial

Study status: Completed
Study dates: Mar 1996 — Jul 1999

The ARMA study was a randomized, controlled multi-center 2 x 2 factorial study consisting of a drug treatment (Ketoconazole vs. placebo) and a ventilation strategy (6ml/kg tidal volume vs. 12ml/kg tidal volume).

Lower Tidal Volume / Higher PEEP Reference Card

Mechanical ventilation protocol summary of low tidal volume used in the ALVEOLI study.

Predicted Body Weight Calculator

Tidal volumes for the ARMA study were based on predicted body weight (PBW). This is a calculation based on age, gender and height. The following are reference tables with PBW calculated for 4-8ml tidal volumes for males and females.

Formula: Males: PBW (kg) = 50 + 2.3 (height (in) – 60); Females: PBW (kg) = 45.5 + 2.3 (height (in) – 60)

Comparison of the SpO2/FIO2 Ratio and the PaO2/FIO2 Ratio in Patients With Acute Lung Injury or ARDS

Publication TypeJournal Article
Year of Publication2007
AuthorsRice, TW; Wheeler, AP; Bernard, GR; Hayden, DL; Schoenfeld, DA; Ware, LB
Journal TitleChest
Volume132
Issue2
Pagination410-417
Key Wordsacute lung injury; ARDS; definition; Pao2/fraction of inspired oxygen ratio
AbstractBackground: The diagnostic criteria for acute lung injury (ALI) and ARDS utilize the PaO2/ fraction of inspired oxygen (FIO2) [P/F] ratio measured by arterial blood gas analysis to assess the degree of hypoxemia. We hypothesized that the pulse oximetric saturation (SpO2)/FIO2 (S/F) ratio can be substituted for the P/F ratio in assessing the oxygenation criterion of ALI. Methods: Corresponding measurements of SpO2 (values < 97%) and PaO2 from patients enrolled in the ARDS Network trial of a lower tidal volume ventilator strategy (n = 672) were compared to determine the relationship between S/F and P/F. S/F threshold values correlating with P/F ratios of 200 (ARDS) and 300 (ALI) were determined. Similar measurements from patients enrolled in the ARDS Network trial of lower vs higher positive end-expiratory pressure (n = 402) were utilized for validation. Results: In the derivation data set (2,613 measurements), the relationship between S/F and P/F was described by the following equation: S/F = 64 + 0.84 * (P/F) [p < 0.0001; r = 0.89]. An S/F ratio of 235 corresponded with a P/F ratio of 200, while an S/F ratio of 315 corresponded with a P/F ratio of 300. The validation database (2,031 measurements) produced a similar linear relationship. The S/F ratio threshold values of 235 and 315 resulted in 85% sensitivity with 85% specificity and 91% sensitivity with 56% specificity, respectively, for P/F ratios of 200 and 300. Conclusion: S/F ratios correlate with P/F ratios. S/F ratios of 235 and 315 correlate with P/F ratios of 200 and 300, respectively, for diagnosing and following up patients with ALI and ARDS.

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)

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