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The proposal.

Cohort, multicenter and multinational study, which will evaluate adherence to low tidal volume in spontaneous ventilatory modes in patients with hypoxemic acute respiratory failure, hospitalized in Intensive Care Units (ICU) and under invasive mechanical ventilation.

SPIRAL is a partnership study between BRICNet (Brazilian Intensive Care Network) and LIVEN (Latin America Intensive Care Network). It is a simplified 24-hour and 28-day follow-up study in ICUs in ten countries in Latin America.

The main objective is to estimate the prevalence of low tidal volume (Vt < 8 mL/kg of ideal weight) in the first 24 hours of spontaneous MV in patients with acute respiratory failure.

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