biostudies-literatureMcNamee JJNational Institute for Health Research (NIHR)Health Research BoardPublic Health Agency1013-1023https://www.ebi.ac.uk/biostudies/studies/S-EPMC8408762biostudies-literatureUnknown326(11)<h4>Importance</h4>In patients who require mechanical ventilation for acute hypoxemic respiratory failure, further reduction in tidal volumes, compared with conventional low tidal volume ventilation, may improve outcomes.<h4>Objective</h4>To determine whether lower tidal volume mechanical ventilation using extracorporeal carbon dioxide removal improves outcomes in patients with acute hypoxemic respiratory failure.<h4>Design, setting, and participants</h4>This multicenter, randomized, allocation-concealed, open-label, pragmatic clinical trial enrolled 412 adult patients receiving mechanical ventilation for acute hypoxemic respiratory failure, of a planned sample size of 1120, between May 2016 and December 2019 from 51 intensive care units in the UK. Follow-up ended on March 11, 2020.<h4>IntJAMAEffect of Lower Tidal Volume Ventilation Facilitated by Extracorporeal Carbon Dioxide Removal vs Standard Care Ventilation on 90-Day Mortality in Patients With Acute Hypoxemic Respiratory Failure: The REST Randomized Clinical Trial.PMC8408762EAT/5105/1413/143/02CTN-2014-012Cabrelli LGibson SWoods LDrummond AYoung DBentley ABrealey DAHu YGunter UWilliams KWilliams JCharlton MAngus IRae JSutton PJames SPerkins GPatel SWright CBanach DWinnard SWalker JSalaunkey KMillar JECurtin JAuzinger GGrainger LChristie LCrews MLankester LGibson CCreighton LMcLaughlin MFelton TCocks EFilipe HBodenham AHartley LAndrew GSummers CWaugh VAgus AMunt SHoward KFitchett JZhao XKelly APatch SMcCulloch CMorgan MPKaur Bhuie PJenkins SCornell SDonnelly ACorbett CBean SGoundry SSpruce EScott SWRoy ABannon LVuylsteke ATurner-Bone IPogson DCathcart SScott TEGillies MABoyle AJCamporota LZolfaghari PPrice GCGanguly SMcNeil MMolina EDooley NRaper MHusain TDevaramani MSnelson CCarter JRostron AWells CMuldoon SMcDowell CHutter JAnand Iyer GCatelan-Zborowski ALinhartova LHill HBall JFarrah HFarnell SEllis KTunnicliffe WBergin CMcGhee CDunn LMills JCampos SPuxty AHarkett SMacGill SBercades GCahill HChukkambotla SCabreros LLim RGriffiths MNutt CNordin NAdedoyin TWilcox DGellamucho MSmyth DJackson CMcNamee LMpelembue MSathianathan VWalsh TCherian SDunn MJDempsey GGilfeather LCrooks NMartin DDespy LBigham CDennis AMee LPooni JJacques NHowcroft CDean MWilby ECooper LMarkham ACooper ICarrera RGillon SEastgate CClark AThrush JColeman NHallett KTalbot NArbane GMartin TRyu JDoble PHodkinson GWelters ICottam VLedot SDavies RJohnston BPage VInnes RConway Morris ARyan CDavies MTully RPGresty JBarrett NADaly ZJohnston PClark RMcCann JClark SPerkins GDAdeniji KDormand NChampanerkar SPaton LMason NShaw DHenderson SDocking RHass IScaife LCole JO'Kane SPope MCole SConnaughton EMason TREST InvestigatorsIlano DMelody TKennedy-Hay SBlack EAustin KDay CJones-Criddle CSampson JAustin PSzakmany TPolgarova PBrett SHarrison-Briggs DClement IVeenith THemmings NMacCallum NSMcAuley DFCamsooksai JDavidson ACarungcong JBarclay LDermody SMackay ACorreia CBociek ABannard-Smith JMcGinley-Keag LGopal SAndreou PSingh SMcNamee JJParekh DBurt KHulme JBrooks JBirkinshaw IBrodie DParamasivam EBooth MGFinney SWilding LTully RO'Neill APinto MGammon BBarcraft-Barnes HReschreiter HWhitehouse ALong FWard KAherne CFinney CLeaver SPriya Maria JTempleton MWalden AGrau Novellas NBowyer CRose SSpivey MPurdy LYoung NHHarrison DASim MSmith HWhitton CSmallwood ASmith JMaclean SKannan SWhitehouse TBhardwaj SBeale RCampbell AGross JMellis CCouper KFellows EGordon AShanbhag SfalseEffect of Lower Tidal Volume Ventilation Facilitated by Extracorporeal Carbon Dioxide Removal vs Standard Care Ventilation on 90-Day Mortality in Patients With Acute Hypoxemic Respiratory Failure: The REST Randomized Clinical Trial.<h4>Importance</h4>In patients who require mechanical ventilation for acute hypoxemic respiratory failure, further reduction in tidal volumes, compared with conventional low tidal volume ventilation, may improve outcomes.<h4>Objective</h4>To determine whether lower tidal volume mechanical ventilation using extracorporeal carbon dioxide removal improves outcomes in patients with acute hypoxemic respiratory failure.<h4>Design, setting, and participants</h4>This multicenter, randomized, allocation-concealed, open-label, pragmatic clinical trial enrolled 412 adult patients receiving mechanical ventilation for acute hypoxemic respiratory failure, of a planned sample size of 1120, between May 2016 and December 2019 from 51 intensive care units in the UK. Follow-up ended on March 11, 2020.<h4>Int2021-01-01T00:00:00Z2021 Sep2026-05-08T19:57:04.456Z2025-02-19T03:26:59.489ZS-EPMC84087623446370010.1001/jama.2021.13374