![]() We recommend using the NIH National Heart, Lung, and Blood Institute ARDS Network PBW equation because it is associated with the clinical trial that identified 6 mL/kg PBW as an appropriate target. Studies should adopt a standard PBW equation. Significant differences between PBW equations for both men and women could be important sources of interstudy variation. Actual differences for clinical trial subjects were as high as 15% for men and 24% for women. The largest mathematical differences were present in older, shorter subjects, especially women. Mathematical differences between PBW equations at limits of height and age exceeded 30% in women and 24% in men for ACTUARIAL vs ARDSNet and about 25% for women and 15% for men for STEWART vs ARDSNet. The ACTUARIAL and ARDSNet surfaces for women were the only surfaces that intersected and produced both positive and negative differences. Significant potential differences existed between these PBW predictions. As a result, lowtidal volume ventilation (LTVV) is now recommended for all patients with ARDS, although penetration of this evidence-based practice has been limited, especially early in. We then used age and height from actual clinical trial subjects to quantify PBW equation differences. A previous study demonstrated improved survival among patients with ARDS receiving tidal volume (Vt) targeted to 6 ml/kg of predicted body weight (PBW). We used three-dimensional and two-dimensional surface analysis to compare these PBW equations. We compared National Institutes of Health (NIH) ARDS Network (ARDSNet), actuarial table (ACTUARIAL), and Stewart (STEWART) PBW equations used in clinical trials, across physiologic ranges for age and height. PBW equations use height, age, and sex as input variables. ![]() Different PBW equations might introduce important differences in tidal volumes delivered to research subjects and patients. Recent recommendations for lung protective mechanical ventilation include a tidal volume target of 6 mL/kg predicted body weight (PBW). ![]()
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