Summary
This pragmatic randomised controlled trial evaluated whether adding periodic sigh breaths (delivering higher tidal volumes to achieve plateau pressures of 35 cm H₂O) to usual care improved outcomes in trauma patients requiring mechanical ventilation. Among 524 enrolled patients across 15 US academic trauma centres, the sigh intervention yielded a modest increase in ventilator-free days (adjusted mean difference 1.4 days, 95% CI −0.2 to 3.0) and was associated with reduced 28-day mortality (11.6% vs 17.6%, P = .05) compared to usual care alone, though the primary endpoint did not reach statistical significance.
UK applicability
The findings may be applicable to UK trauma centres and intensive care units managing mechanically ventilated trauma patients, though adoption would require alignment with local ventilation protocols and consideration of equipment capabilities across NHS trusts.
Key measures
Median ventilator-free days; 28-day mortality rate; plateau pressure (cm H₂O); adverse events
Outcomes reported
The study measured ventilator-free days as the primary outcome and 28-day all-cause mortality as a prespecified secondary outcome in trauma patients receiving mechanical ventilation.
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