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Comparison of Two Fluid-Management Strategies in Acute Lung Injury The National Heart, Lung, and Blood Institute Acute Respiratory Distress Syndrome (ARDS) Clinical Trials Network* N Engl J Med, May, 2006;354:2564-75. Presented by  ่‘‰ๅญๆดช Supervisor  ๆฅŠไฟŠๆฐ้†ซๅธซ ๆœฌๆช”ๅƒ…ไพ›ๅ…ง้ƒจๆ•™ๅญธไฝฟ็”จ ๆช”ๆกˆๅ…งๆ‰€ไฝฟ็”จไน‹็…ง็‰‡ไน‹็‰ˆๆฌŠไปๅฑฌๆ–ผๅŽŸๆœŸๅˆŠ ๅ…ฌ้–‹ไฝฟ็”จๆ™‚ ,  ้ ˆ็ฒๅพ—ๅŽŸๆœŸๅˆŠไน‹ๅŒๆ„ๆŽˆๆฌŠ
Introduction ,[object Object],[object Object],[object Object],[object Object]
Introduction ,[object Object],[object Object]
Study design ,[object Object],[object Object]
Inclusion Criteria ,[object Object],[object Object],[object Object]
Exclusion Criteria ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Study Procedures ,[object Object],[object Object],[object Object]
Study Procedures ,[object Object],[object Object]
Study Procedures ,[object Object],[object Object]
ย 
Protocols ,[object Object],[object Object],[object Object]
Organ Failure ,[object Object],[object Object],[object Object]
Statistical Analysis ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Results ,[object Object],[object Object],[object Object]
ย 
ย 
ย 
Protocol Conduct and Instructions 19% 21% Drotrecogin alfa use 32% 37% Systemic corticosteroids 29% 39% At least one blood transfusion 6% 4% Dobutamine use 6% 15% Fluid bolus 41% 10% Received furosemide 4.1 5.1 Protocol instructions per day 88% 91% The rate of compliance with instructions 43.8ยฑ2.5 41.3 ยฑ1.6 The mean time from admission to the ICU to the first protocol instruction. (hours) Conservative Liberal
Fluid Balance ,[object Object],[object Object]
ย 
ย 
Fluid Balance โˆ’ 1576 ยฑ 519 ml 5287 ยฑ 576 ml No shock at baseline, the cumulative seven-day fluid balance 2904 ยฑ 1008 ml 10,138 ยฑ 922 ml Shock at baseline,  the cumulative seven-day fluid balance Conservative Liberal
ย 
Hemodynamics ,[object Object],[object Object]
ย 
Lung Function ,[object Object],[object Object]
ย 
Metabolic and Renal Function ,[object Object],[object Object]
ย 
Safety ,[object Object]
Major Outcomes ,[object Object],[object Object],[object Object],[object Object]
ย 
ย 
ย 
Discussion ,[object Object],[object Object]
Discussion ,[object Object],[object Object],[object Object]
Discussion ,[object Object],[object Object],[object Object]
Discussion ,[object Object],[object Object],[object Object]
Discussion ,[object Object],[object Object],[object Object]
Discussion ,[object Object],[object Object],[object Object]
Discussion ,[object Object],[object Object]
Discussion ,[object Object],[object Object]
Conclusion ,[object Object],[object Object]

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17 capnography part4 non-intubated
17 capnography part4 non-intubated17 capnography part4 non-intubated
17 capnography part4 non-intubated
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16 capnography part3 intubated
16 capnography part3 intubated16 capnography part3 intubated
16 capnography part3 intubated
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15 capnography part2 introduction
15 capnography part2 introduction15 capnography part2 introduction
15 capnography part2 introduction
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14 capnography part1 overview
14 capnography part1 overview14 capnography part1 overview
14 capnography part1 overview
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13 icu monitoring standards and capnography
13 icu monitoring standards and capnography13 icu monitoring standards and capnography
13 icu monitoring standards and capnography
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12 mainstream sidestream capnpgraphy
12 mainstream   sidestream capnpgraphy12 mainstream   sidestream capnpgraphy
12 mainstream sidestream capnpgraphy
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Comparison of two fluid management strategies in acute lung injury

  • 1. Comparison of Two Fluid-Management Strategies in Acute Lung Injury The National Heart, Lung, and Blood Institute Acute Respiratory Distress Syndrome (ARDS) Clinical Trials Network* N Engl J Med, May, 2006;354:2564-75. Presented by ่‘‰ๅญๆดช Supervisor ๆฅŠไฟŠๆฐ้†ซๅธซ ๆœฌๆช”ๅƒ…ไพ›ๅ…ง้ƒจๆ•™ๅญธไฝฟ็”จ ๆช”ๆกˆๅ…งๆ‰€ไฝฟ็”จไน‹็…ง็‰‡ไน‹็‰ˆๆฌŠไปๅฑฌๆ–ผๅŽŸๆœŸๅˆŠ ๅ…ฌ้–‹ไฝฟ็”จๆ™‚ , ้ ˆ็ฒๅพ—ๅŽŸๆœŸๅˆŠไน‹ๅŒๆ„ๆŽˆๆฌŠ
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  • 18. Protocol Conduct and Instructions 19% 21% Drotrecogin alfa use 32% 37% Systemic corticosteroids 29% 39% At least one blood transfusion 6% 4% Dobutamine use 6% 15% Fluid bolus 41% 10% Received furosemide 4.1 5.1 Protocol instructions per day 88% 91% The rate of compliance with instructions 43.8ยฑ2.5 41.3 ยฑ1.6 The mean time from admission to the ICU to the first protocol instruction. (hours) Conservative Liberal
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  • 22. Fluid Balance โˆ’ 1576 ยฑ 519 ml 5287 ยฑ 576 ml No shock at baseline, the cumulative seven-day fluid balance 2904 ยฑ 1008 ml 10,138 ยฑ 922 ml Shock at baseline, the cumulative seven-day fluid balance Conservative Liberal
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