The Science Journal of the American Association for Respiratory Care

2001 OPEN FORUM Abstracts

IMPLEMENTATIONOF LOW VOLUME VENTILATION FOR ARDS PATIENTS IN A TERTIARY CARE FACILITY

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Mark TurleyCRT, Allyson Callahan BS RRT, Anne Freel RRT, William Linane RRT,Nancy Collar BA RRT, Michael Lavery RRT, James Lamberti MD. Inova Fairfax Hospital,Falls Church, VA.

BACKGROUND: In May of 2000,the National Heart Lung Blood Institute?s Acute Respiratory Distress SyndromeNetwork (ARDS Net) published a study in the New England Journal of Medicine.The report concluded that the application of a low tidal volume (VT)ventilation strategy could significantly reduce mortality in ARDS/Acute LungInjury (ALI) patients.

METHOD: We undertook a QIproject with our Pulmonary Medicine section comparing ventilation in ARDS/ALIpatients with those of the ARDS Network trial. The published trial data wasintroduced to the Pulmonary, Medicine, and Surgical sections of physicians,as well as the Respiratory Care Practitioners (RCPs). During a three-month period,we reviewed records of all patients in our Intensive Care Units (ICUs) to determinewhether they met ARDS/ALI criteria (chest radiographs, PaO2/FiO2ratio, and risk factor). RCPs calculated the ideal body weight (IBW) on allpatients who met these criteria, and then encouraged physicians to follow theventilation protocol using 6cc/kg VT. We then analyzed an additionalthree-month period to determine (i.) whether there was any improvement fromthe initial study baseline and (ii.) where education needed to be applied toimprove treatment protocols.

Results: We noticed that weneeded a more directed education program to improve the way we ventilated ARDS/ALIpatients.

Conclusions: With this informationwe will be able to improve the management of ARDS patients at our facility.This project will allow us to concentrate and improve our educational needs.

 

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