OBJECTIVE: Use of lung-protective mechanical ventilation (MV) by applying lower tidal volumes is recommended in patients suffering from acute lung injury (ALI) or acute respiratory distress syndrome (ARDS). Recent data suggest that lung-protective MV may benefit non-ALI/ARDS patients as well. This study analyzed tidal volume settings in three ICUs in The Netherlands to determine the effect of feedback and education concerning use of lung-protective MV. DESIGN AND SETTING: Observational study in one academic and two nonacademic "closed format" ICUs. PATIENTS: Intubated mechanically ventilated subjects. INTERVENTIONS: Feedback and education concerning lung-protective MV with special attention to the importance of closely adjusting tidal volumes to predicted body weight (PBW). RESULTS: Tidal volumes declined significantly within 6 months after intervention (from 9.8+/-2.0 at baseline to 8.1+/-1.7 ml/kg PBW) as the percentage of undesirable ventilation data points, defined as tidal volumes greater than 8 ml/kg PBW (84% vs. 48%). There were no differences between patients meeting the international definition criteria for ALI/ARDS and those not. Only four patients received tidal volumes less than 6 ml/kg PBW. Lower tidal volumes were still used after 12 months. Tidal volumes in patients on mandatory MV and patients breathing on spontaneous modes were similar. CONCLUSIONS: Feedback and education improve physician compliance in use of lung-protective MV.
OBJECTIVE: Use of lung-protective mechanical ventilation (MV) by applying lower tidal volumes is recommended in patients suffering from acute lung injury (ALI) or acute respiratory distress syndrome (ARDS). Recent data suggest that lung-protective MV may benefit non-ALI/ARDSpatients as well. This study analyzed tidal volume settings in three ICUs in The Netherlands to determine the effect of feedback and education concerning use of lung-protective MV. DESIGN AND SETTING: Observational study in one academic and two nonacademic "closed format" ICUs. PATIENTS: Intubated mechanically ventilated subjects. INTERVENTIONS: Feedback and education concerning lung-protective MV with special attention to the importance of closely adjusting tidal volumes to predicted body weight (PBW). RESULTS: Tidal volumes declined significantly within 6 months after intervention (from 9.8+/-2.0 at baseline to 8.1+/-1.7 ml/kg PBW) as the percentage of undesirable ventilation data points, defined as tidal volumes greater than 8 ml/kg PBW (84% vs. 48%). There were no differences between patients meeting the international definition criteria for ALI/ARDS and those not. Only four patients received tidal volumes less than 6 ml/kg PBW. Lower tidal volumes were still used after 12 months. Tidal volumes in patients on mandatory MV and patients breathing on spontaneous modes were similar. CONCLUSIONS: Feedback and education improve physician compliance in use of lung-protective MV.
Authors: G R Bernard; A Artigas; K L Brigham; J Carlet; K Falke; L Hudson; M Lamy; J R Legall; A Morris; R Spragg Journal: Am J Respir Crit Care Med Date: 1994-03 Impact factor: 21.405
Authors: M B Amato; C S Barbas; D M Medeiros; R B Magaldi; G P Schettino; G Lorenzi-Filho; R A Kairalla; D Deheinzelin; C Munoz; R Oliveira; T Y Takagaki; C R Carvalho Journal: N Engl J Med Date: 1998-02-05 Impact factor: 91.245
Authors: Gordon D Rubenfeld; Claudette Cooper; Greg Carter; B Taylor Thompson; Leonard D Hudson Journal: Crit Care Med Date: 2004-06 Impact factor: 7.598
Authors: Peter Andrews; Elie Azoulay; Massimo Antonelli; Laurent Brochard; Christian Brun-Buisson; Daniel de Backer; Geoffrey Dobb; Jean-Yves Fagon; Herwig Gerlach; Johan Groeneveld; Jordi Mancebo; Philipp Metnitz; Stefano Nava; Jerome Pugin; Michael Pinsky; Peter Radermacher; Christian Richard; Robert Tasker Journal: Intensive Care Med Date: 2006-02-01 Impact factor: 17.440
Authors: Curtis H Weiss; Jerry A Krishnan; David H Au; Bruce G Bender; Shannon S Carson; Adithya Cattamanchi; Michelle M Cloutier; Colin R Cooke; Karen Erickson; Maureen George; Joe K Gerald; Lynn B Gerald; Christopher H Goss; Michael K Gould; Robert Hyzy; Jeremy M Kahn; Brian S Mittman; Erika M Mosesón; Richard A Mularski; Sairam Parthasarathy; Sanjay R Patel; Cynthia S Rand; Nancy S Redeker; Theodore F Reiss; Kristin A Riekert; Gordon D Rubenfeld; Judith A Tate; Kevin C Wilson; Carey C Thomson Journal: Am J Respir Crit Care Med Date: 2016-10-15 Impact factor: 21.405
Authors: David J Murphy; Peter J Pronovost; Christoph U Lehmann; Ayse P Gurses; Glenn J R Whitman; Dale M Needham; Sean M Berenholtz Journal: Transfusion Date: 2014-05-21 Impact factor: 3.157
Authors: Dharmvir S Jaswal; Janice M Leung; Junfeng Sun; Xizhong Cui; Yan Li; Steven Kern; Judith Welsh; Charles Natanson; Peter Q Eichacker Journal: Crit Care Med Date: 2014-10 Impact factor: 7.598