{
  "abstract": "Ultra-low tidal volume ventilation (ULTV) aims to minimize ventilator-induced lung injury in acute respiratory distress syndrome (ARDS), but is associated with an increase in arterial carbon dioxide (PaCO 2 ). This follow-up study aimed to evaluate whether ULTV impacted long-term pre-specified secondary outcomes in the VT4COVID trial. VT4COVID was an open-label multicenter randomized controlled superiority trial performed in ten French intensive care units. Eligible patients were COVID-19 ARDS patients with arterial oxygen pressure (PaO 2 ) over inspired oxygen fraction (FiO 2 ) ≤ 150 mmHg, randomized to ULTV with tidal volume (VT) 4 mL.kg − 1 predicted body weight (PBW), or low VT ventilation (LTV) with VT 6 mL.kg − 1 PBW. Participants, investigators, and outcome assessors were unblinded to group assignment. The following prespecified secondary outcomes were assessed at day-365: MoCA 5-minute, SF-36 and IES-R scores; mortality at day-365 was added a posteriori as an outcome. Scores were compared between arms with the Mann-Whitney test, and mortality was compared between groups with a Cox proportional-hazard model. All analyses (except mortality at day-365) were conducted according to a modified intention-to-treat principle. Two hundred and fifteen patients were randomized to ULTV ( n = 106) or LTV ( n = 109) between April,2020 and April,2021. Seven patients were lost to follow-up and 34 surviving patients had missing data for at least one score. Mortality at day-365 was not significantly different between ULTV and LTV arms (47/102 [46%] vs. 44/106 [42%], hazard ratio 1.19 (95% confidence interval (CI 95% ):0.79–1.80)). The other secondary outcomes were evaluated in 39/55 [71%] and 44/62 [71%] patients in the ULTV and LTV arm, respectively. The MoCA 5-minute score was significantly lower in the ULTV arm (median difference: -2 [CI 95% :-4–0] points, p < 0.05). There was no significant difference in SF-36 and IES-R scores between groups. In a post-hoc analysis, MoCA 5-minute score was significantly associated with area under curve (AUC) or maximal PaCO 2 during ARDS management ( p < 0.01), but not with AUC or minimal PaO 2 . ULTV is associated with a small but significant decrease in cognitive status at day-365 possibly related to exposure to higher PaCO 2 . The trial was prospectively registered with ClinicalTrials.gov (NCT04349618) on April 16, 2020.",
  "abstract_shown": true,
  "affiliations": [],
  "article_type": null,
  "arxiv": null,
  "author_total": 21,
  "authors": [
    {
      "name": "Jean-Christophe Richard"
    },
    {
      "name": "Fatima Chorfa"
    },
    {
      "name": "Nicolas Terzi"
    },
    {
      "name": "Hodane Yonis"
    },
    {
      "name": "Florent Wallet"
    },
    {
      "name": "Claire Dupuis"
    },
    {
      "name": "Laurent Argaud"
    },
    {
      "name": "Bertrand Delannoy"
    },
    {
      "name": "Guillaume Thiery"
    },
    {
      "name": "Gaël Bourdin"
    },
    {
      "name": "Thomas Rimmele"
    },
    {
      "name": "Michel Muller"
    },
    {
      "name": "Florian Sigaud"
    },
    {
      "name": "Guillaume Rigault"
    },
    {
      "name": "Emilie Joffredo"
    },
    {
      "name": "Mehdi Mezidi"
    },
    {
      "name": "Bertrand Souweine"
    },
    {
      "name": "Loredana Baboi"
    },
    {
      "name": "Hassan Serrier"
    },
    {
      "name": "Muriel Rabilloud"
    },
    {
      "name": "Laurent Bitker"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/1gjhne6tax9s3.bib",
  "cited_by": 0,
  "doi": "10.1186/s13054-026-06195-3",
  "fulltext_url": null,
  "id": "1gjhne6tax9s3",
  "issns": [
    "1364-8535",
    "1466-609X"
  ],
  "landing_url": "https://hal.science/hal-05751757v1",
  "language": "en",
  "licence": "CC-BY-NC-ND",
  "licence_label": "CC BY-NC-ND",
  "licence_source": "journal",
  "licence_url": "https://creativecommons.org/licenses/by-nc-nd/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "hal",
      "0.sdv"
    ],
    [
      "hal",
      "1.sdv.spee"
    ],
    [
      "openalex",
      "2740|Respiratory Support and Mechanisms"
    ]
  ],
  "openalex": "W7168274705",
  "pdf_url": null,
  "pmcid": null,
  "pmid": "42449426",
  "published": "2026-07-14",
  "publisher": "BioMed Central",
  "ris": "https://research.draconitic.com/paper/1gjhne6tax9s3.ris",
  "sources": [
    {
      "first_seen": "2026-10-30T12:17:35Z",
      "native_id": "hal-05751757",
      "source": "hal",
      "url": "https://hal.science/hal-05751757v1"
    }
  ],
  "subjects": [
    {
      "field": "biology",
      "origin": "hal:0.sdv",
      "subfield": "general"
    },
    {
      "field": "medicine",
      "origin": "hal:1.sdv.spee",
      "subfield": "epidemiology-public-health"
    }
  ],
  "title": "Impact of ultra-low tidal volume ventilation on 1-year functional outcome in COVID-19 ARDS patients. A long-term follow-up analysis of a randomized controlled trial",
  "title_text": "Impact of ultra-low tidal volume ventilation on 1-year functional outcome in COVID-19 ARDS patients. A long-term follow-up analysis of a randomized controlled trial",
  "type": "peer-reviewed",
  "updated_at": "2026-10-30T12:17:35Z",
  "url": "https://research.draconitic.com/paper/1gjhne6tax9s3",
  "venue": "Critical Care",
  "versions": []
}