Abstract
Ventilator strategies that use tidal volumes (TVs) limited to 6 ml/kg IBW (ideal body weight) have been shown to reduce mortality in patients with ARDS (acute respiratory distress syndrome). [1] It is suggested that using these same low tidal volumes in other critically ill patients may reduce the progression to ARDS. [2, 3] An initial audit in the ICU at University Hospital Lewisham demonstrated that patients without ARDS were receiving mandatory ventilation in excess of 8 ml/kg IBW >40% of the time.
Highlights
[1] It is suggested that using these same low tidal volumes in other critically ill patients may reduce the progression to ARDS. [2,3] An initial audit in the ICU at University Hospital Lewisham demonstrated that patients without ARDS were receiving mandatory ventilation in excess of 8 ml/kg IBW >40% of the time
Data was collected on all ventilated patients without ARDS during three 21-day periods: an initial audit (Febuary 2013); a re-audit following the initiation of the protocol and education program (June 2013); a subsequent reaudit following redrafting of the protocol and introduction of PRVC (Pressure Regulated Volume Control) as the default mode of mandatory ventilation (November 2013)
During the second re-audit period 15 patients received a total of 846 hours of mandatory ventilation, of which 33.4% was >8 ml/kg IBW (p = 0.001) (Figure 1)
Summary
Ventilator strategies that use tidal volumes (TVs) limited to 6 ml/kg IBW (ideal body weight) have been shown to reduce mortality in patients with ARDS (acute respiratory distress syndrome). [1] It is suggested that using these same low tidal volumes in other critically ill patients may reduce the progression to ARDS. [2,3] An initial audit in the ICU at University Hospital Lewisham demonstrated that patients without ARDS were receiving mandatory ventilation in excess of 8 ml/kg IBW >40% of the time
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