Ambassador Blog Series: Sep Rejai from U. of Michigan on The Acute Respiratory Distress Syndrome Network

January 7, 2015

Sep Rejai Michigan Docphin Ambassador

Name:  Sep Rejai, 4th year Medical Student
Institution: University of Michigan
Undergrad: UC Davis
Specialty Interest: Anesthesiology/Intensive Care Medicine

I was born in Tehran, Iran and moved to the United States in high school.  Throughout medical school, I’ve kept my equilibrium by rocking out in a band called Saturday Night Palsy as the guitarist.  Also, in these past four years, I’ve travelled back to Iran several times and drove a taxicab in Tehran. Other interests outside of medicine include translating children’s literature from English to Farsi… I’ve translated two books so far.  

Trial: Ventilation with lower tidal volumes as compared with traditional tidal volumes for acute lung injury and the acute respiratory distress syndrome. The Acute Respiratory Distress Syndrome Network.

Journal: New England Journal of Medicine

Date: May 5, 2004


This is a landmark multicenter randomized control trial of patients with acute lung injury who were ventilator dependent in the intensive care unit.  This study changed the paradigm of ventilator management in the ICU and showed that outcomes improve and stretch-induced lung injury and systemic inflammation decrease by prioritizing lower tidal volumes over obtaining perfect blood gases and Ph.

Key Takeaway:
Traditionally, higher tidal volumes of 10-15 ml/kg were the standard of care for this patient population.  This study compared two groups of patients with ARDS: One receiving a tidal volume of 12 ml/kg with a plateau pressure of 50 mmH20 and a second group receiving a lower volume of 6 ml/kg with a plateau pressure of 30 mmH20.  The lower volume group achieved both statistical and clinical significance for decreased mortality and increased ventilator-free days.  The study was terminated early after these remarkable results were discovered.

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