Andrew J Stoltze1, Terrence S Wong1, Karisa K Harland1, Azeemuddin Ahmed1, Brian M Fuller2, Nicholas M Mohr3. 1. Department of Emergency Medicine, University of Iowa Carver College of Medicine, Iowa City, IA 52242. 2. Division of Emergency Medicine, Washington University School of Medicine, St. Louis, MO 63110; Division of Critical Care, Department of Anesthesiology, Washington University School of Medicine, St. Louis, MO 63110. 3. Department of Emergency Medicine, University of Iowa Carver College of Medicine, Iowa City, IA 52242; Division of Critical Care, Department of Anesthesia, University of Iowa Carver College of Medicine, Iowa City, IA 52242. Electronic address: nicholas-mohr@uiowa.edu.
Abstract
PURPOSE: The purposes of the study are to describe current practice of ventilation in a modern air medical system and to measure the association of ventilation strategy with subsequent ventilator care and acute respiratory distress syndrome (ARDS). MATERIALS AND METHODS: Retrospective observational cohort study of intubated adult patients (n = 235) transported by a university-affiliated air medical transport service to a 711-bed tertiary academic center between July 2011 and May 2013. Low tidal volume ventilation was defined as tidal volumes less than or equal to 8 mL/kg predicted body weight. Multivariable regression was used to measure the association between prehospital tidal volume, hospital ventilation strategy, and ARDS. RESULTS: Most patients (57%) were ventilated solely with bag valve ventilation during transport. Mean tidal volume of mechanically ventilated patients was 8.6 mL/kg predicted body weight (SD, 0.2 mL/kg). Low tidal volume ventilation was used in 13% of patients. Patients receiving low tidal volume ventilation during air medical transport were more likely to receive low tidal volume ventilation in the emergency department (P < .001) and intensive care unit (P = .015). Acute respiratory distress syndrome was not associated with prehospital tidal volume (P = .840). CONCLUSIONS: Low tidal volume ventilation was rare during air medical transport. Air transport ventilation strategy influenced subsequent ventilation but was not associated with ARDS.
PURPOSE: The purposes of the study are to describe current practice of ventilation in a modern air medical system and to measure the association of ventilation strategy with subsequent ventilator care and acute respiratory distress syndrome (ARDS). MATERIALS AND METHODS: Retrospective observational cohort study of intubated adult patients (n = 235) transported by a university-affiliated air medical transport service to a 711-bed tertiary academic center between July 2011 and May 2013. Low tidal volume ventilation was defined as tidal volumes less than or equal to 8 mL/kg predicted body weight. Multivariable regression was used to measure the association between prehospital tidal volume, hospital ventilation strategy, and ARDS. RESULTS: Most patients (57%) were ventilated solely with bag valve ventilation during transport. Mean tidal volume of mechanically ventilated patients was 8.6 mL/kg predicted body weight (SD, 0.2 mL/kg). Low tidal volume ventilation was used in 13% of patients. Patients receiving low tidal volume ventilation during air medical transport were more likely to receive low tidal volume ventilation in the emergency department (P < .001) and intensive care unit (P = .015). Acute respiratory distress syndrome was not associated with prehospital tidal volume (P = .840). CONCLUSIONS: Low tidal volume ventilation was rare during air medical transport. Air transport ventilation strategy influenced subsequent ventilation but was not associated with ARDS.
Authors: E Rivers; B Nguyen; S Havstad; J Ressler; A Muzzin; B Knoblich; E Peterson; M Tomlanovich Journal: N Engl J Med Date: 2001-11-08 Impact factor: 91.245
Authors: M Gausche; R J Lewis; S J Stratton; B E Haynes; C S Gunter; S M Goodrich; P D Poore; M D McCollough; D P Henderson; F D Pratt; J S Seidel Journal: JAMA Date: 2000-02-09 Impact factor: 56.272
Authors: V M Ranieri; P M Suter; C Tortorella; R De Tullio; J M Dayer; A Brienza; F Bruno; A S Slutsky Journal: JAMA Date: 1999-07-07 Impact factor: 56.272
Authors: Ognjen Gajic; Saqib I Dara; Jose L Mendez; Adebola O Adesanya; Emir Festic; Sean M Caples; Rimki Rana; Jennifer L St Sauver; James F Lymp; Bekele Afessa; Rolf D Hubmayr Journal: Crit Care Med Date: 2004-09 Impact factor: 7.598
Authors: Brian M Fuller; Ian T Ferguson; Nicholas M Mohr; Anne M Drewry; Christopher Palmer; Brian T Wessman; Enyo Ablordeppey; Jacob Keeperman; Robert J Stephens; Cristopher C Briscoe; Angelina A Kolomiets; Richard S Hotchkiss; Marin H Kollef Journal: Crit Care Med Date: 2017-04 Impact factor: 7.598
Authors: Brendan P George; J Priyanka Vakkalanka; Karisa K Harland; Brett Faine; Stacey Rewitzer; Anne Zepeski; Brian M Fuller; Nicholas M Mohr; Azeemuddin Ahmed Journal: Prehosp Emerg Care Date: 2020-01-23 Impact factor: 3.077
Authors: Michael J Lanspa; Michelle Ng Gong; David A Schoenfeld; Kathleen Tiffany Lee; Colin K Grissom; Peter C Hou; Ary Serpa-Neto; Samuel M Brown; Theodore J Iwashyna; Donald M Yealy; Catherine L Hough; Roy G Brower; Carolyn S Calfee; Robert C Hyzy; Michael A Matthay; Russell R Miller; Jay S Steingrub; B Taylor Thompson; Chadwick D Miller; Terry P Clemmer; Gregory W Hendey; David T Huang; Kusum S Mathews; Nida Qadir; Mark Tidswell Journal: Ann Am Thorac Soc Date: 2019-03