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February 20, 2013

Protective Ventilation for Patients Without Acute Respiratory Distress Syndrome

Author Affiliations

Letters Section Editor: Jody W. Zylke, MD, Senior Editor.

Author Affiliation: Department of Critical Care Medicine, Jinhua Municipal Central Hospital, Jinhua, China (

JAMA. 2013;309(7):654. doi:10.1001/jama.2012.197014

To the Editor: Dr Serpa Neto and colleagues1 addressed the issue of whether the use of protective ventilation would be associated with a benefit in patients without acute respiratory distress syndrome (ARDS). However, this review was not without limitations, including the phenomenon in meta-analyses termed small study effects. Small study effects refer to the fact that small trials are more likely to report beneficial effects in the intervention group.2

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