Table 1Baseline demographic data (mean �� SE)In the PHARLAP group, all 10 patients received daily SRM with maximum PEEP of 40 cm H2O and a maximum plateau airway pressure of 55 cm H2O. Three patients transiently desaturated to < 90% at maximum PEEP of 40 cm H2O with no lasting adverse effects. There was no radiographic evidence of barotrauma during the seven selleck day study period.Two patients from the control group developed severe hypoxaemia (SaO2 �� 90% whilst receiving FiO2 0.9 and PEEP 18) and received rescue therapies (a static recruitment manoeuvre in one and inhaled nitric oxide in the other). One patient in the control group died during the seven-day intervention period. Five patients in the PHARLAP group were weaned from mechanical ventilation within the seven days compared to three in the control group.

At Day 7, there were five PHARLAP group patients and six control group patients who remained on mechanical ventilation.There was evidence to suggest that some cytokine values differed between groups with plasma IL-8 and TNF-�� levels being significantly lower in the PHARLAP group (Figure (Figure2).2). Using an analysis of covariance with baseline values as a covariate, the overall levels of IL-8 over all time points were 41% higher in the control group compared to the PHARLAP group (ratio 1.41 (1.11 to 1.79), P = 0.01). Similarly, overall levels of TNF-�� over all time points were 20% higher in the control group compared to the PHARLAP group (ratio 1.20 (1.01 to 1.42), P = 0.05). There were no statistically significant differences in IL-6 or IL-1�� between the treatment and control groups.

Figure 2IL-8 and TNF-�� measured over 168 hours (seven days) reported as geometric means (95% CI). There was a significant overall difference in interleukin-8 and serum tumour necrosis factor-alpha between the treatment group and the control group over …There was a significant overall improvement in static lung compliance in the PHARLAP group compared to the control group over seven days (49.1 �� 2.9 versus 33.7 �� 2.7 mls/cm H2O, P < 0.001, Figure Figure3).3). PaO2/FIO2 was higher in the PHARLAP group than the control group over the first 24 hours (Figure (Figure4)4) and over 7 days (204 �� 9 versus 165 �� 9 cm H2O, P = 0.005, Figure Figure55).Figure 3Static lung compliance measured in ventilated patients for seven days (mean �� SE).

There was a significant overall improvement in static lung compliance in the PHARLAP group compared to control group patients. A = missing data analysed as random …Figure 4PaO2/FIO2 measured over the first 24 hours in ventilated patients (mean �� SE). PHARLAP group had a significant overall increase in PaO2/FIO2 compared to control group patients (*P < 0.01).Figure Anacetrapib 5PaO2/FIO2 measured over seven days in ventilated patients (mean �� SE).