PURPOSE: The purpose of the study was to measure the effect of a computerized decision support system (CDSS) on adherence to tidal volume (V(T)) recommendations. MATERIALS AND METHODS: We performed a prospective before-after evaluation study on applied V(T) to examine the impact of a CDSS on adherence to our local protocol in a 30-bed mixed medical-surgical intensive care unit of a university hospital. All intensive care unit patients who were intubated and mechanically ventilated for at least 1 hour were included. RESULTS: A total of 3 663 674 V(T) records of 696 patients were analyzed. The average volume greater than 6 mL/kg predicted body weight (PBW) and the mean percentage of ventilation time with V(T) greater than 6 mL/kg PBW decreased after intervention by 6.0% and 3.4%, respectively (not significant). A stronger effect of the decision support intervention was found among patients with longer duration of mechanical ventilation (>24 hours): for these patients, the average V(T) in exceeding 6 mL/kg PBW and the mean percentage of ventilation time with V(T) greater than 6 mL/kg PBW decreased after intervention by 18.3% (P = .01) and 9.5% (P = .01), respectively. In this group, the mean percentage of ventilation time with V(T) records between 8 and 10, between 10 and 12, and greater than 12 mL/kg PBW decreased by 21.8% (P = .006), 21.5% (P = .047), and 24.7% (P = .155), respectively. CONCLUSIONS: The use of a CDSS, integrated in a patient data management system, improves implementation of a lower V(T) mechanical ventilation strategy for patients ventilated for longer than 24 hours.
PURPOSE: The purpose of the study was to measure the effect of a computerized decision support system (CDSS) on adherence to tidal volume (V(T)) recommendations. MATERIALS AND METHODS: We performed a prospective before-after evaluation study on applied V(T) to examine the impact of a CDSS on adherence to our local protocol in a 30-bed mixed medical-surgical intensive care unit of a university hospital. All intensive care unit patients who were intubated and mechanically ventilated for at least 1 hour were included. RESULTS: A total of 3 663 674 V(T) records of 696 patients were analyzed. The average volume greater than 6 mL/kg predicted body weight (PBW) and the mean percentage of ventilation time with V(T) greater than 6 mL/kg PBW decreased after intervention by 6.0% and 3.4%, respectively (not significant). A stronger effect of the decision support intervention was found among patients with longer duration of mechanical ventilation (>24 hours): for these patients, the average V(T) in exceeding 6 mL/kg PBW and the mean percentage of ventilation time with V(T) greater than 6 mL/kg PBW decreased after intervention by 18.3% (P = .01) and 9.5% (P = .01), respectively. In this group, the mean percentage of ventilation time with V(T) records between 8 and 10, between 10 and 12, and greater than 12 mL/kg PBW decreased by 21.8% (P = .006), 21.5% (P = .047), and 24.7% (P = .155), respectively. CONCLUSIONS: The use of a CDSS, integrated in a patient data management system, improves implementation of a lower V(T) mechanical ventilation strategy for patients ventilated for longer than 24 hours.
Authors: Christopher P Bourdeaux; Matthew Jc Thomas; Timothy H Gould; Gaurav Malhotra; Andreas Jarvstad; Timothy Jones; Iain D Gilchrist Journal: BMJ Open Date: 2016-05-26 Impact factor: 2.692
Authors: Briana Short; Alexis Serra; Abdul Tariq; Vivek Moitra; Daniel Brodie; Sapana Patel; Matthew R Baldwin; Natalie H Yip Journal: J Crit Care Date: 2020-09-20 Impact factor: 4.298
Authors: Saeid Eslami; Marjan Askari; Stephanie Medlock; Derk L Arts; Jeremy C Wyatt; Henk C P M van Weert; Sophia E de Rooij; Ameen Abu-Hanna Journal: Trials Date: 2014-03-19 Impact factor: 2.279