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01-04-2005 | Original

Feedback and education improve physician compliance in use of lung-protective mechanical ventilation

Authors: Esther K. Wolthuis, Johanna C. Korevaar, Peter Spronk, Michael A. Kuiper, Misa Dzoljic, Margreeth B. Vroom, Marcus J. Schultz

Published in: Intensive Care Medicine | Issue 4/2005

Abstract

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.

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Title: Feedback and education improve physician compliance in use of lung-protective mechanical ventilation
Authors: Esther K. Wolthuis
Johanna C. Korevaar
Peter Spronk
Michael A. Kuiper
Misa Dzoljic
Margreeth B. Vroom
Marcus J. Schultz
Publication date: 01-04-2005
Publisher: Springer-Verlag
Published in: Intensive Care Medicine / Issue 4/2005
Print ISSN: 0342-4642
Electronic ISSN: 1432-1238
DOI: https://doi.org/10.1007/s00134-005-2581-9

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Feedback and education improve physician compliance in use of lung-protective mechanical ventilation

Abstract

Objective

Design and setting

Patients

Interventions

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Objective

Design and setting

Patients

Interventions

Results

Conclusions

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