The Science Journal of the American Association for Respiratory Care

2009 OPEN FORUM Abstracts

CURRENT PRACTICES RELATED TO LUNG PROTECTIVE STRATEGIES IN PATIENTS WITH ACUTE RESPIRATORY DISTRESS SYNDROME IN OHIO HOSPITALS

Sarah Varekojis, Megan Anzak, Nagham Houssami; Respiratory Therapy Division, The Ohio State University, Columbus, OH

Introduction: Ventilating patients with Acute Respiratory Distress Syndrome (ARDS) and acute lung injury (ALI) is a complex process. There is considerable research on methods of lung protective strategies for ARDS/ALI patients, but little is known about actual use of these strategies. Objective: To explore current practices related to lung protective strategies for patients with ARDS/ALI in Ohio hospitals. Methods: Participants were Ohio licensed respiratory therapists who had current or recent experience in critical care. Survey Monkey® was used to administer a survey that included questions regarding ventilator modes and parameters (tidal volume, respiratory rate, PEEP) used with ARDS/ALI patients as well as the use and implementation of ventilator management protocols for ARDS/ALI patients. The survey was distributed to respiratory therapists that participated in a large state-wide continuing education conference. Descriptive statistics and chi square were used as appropriate to answer research questions. Results: The two most common lung protective strategies being used were tidal volume (Vt) 6-8ml/kg IBW (81%) and optimization of peak end-expiratory pressure (PEEP) (59%). The least common strategy being used was high frequency oscillatory ventilation (HFOV) (16%). 52% of facilities had a ventilator management protocol in place for patients with ARDS/ALI, and 80% indicated that the protocol was being used. Teaching hospitals were more likely to use a Vt 6-8ml/kg, early HFOV, and prone positioning than community hospitals. Conclusion: In Ohio, the majority of both teaching and community hospitals are compliant with ARDSNet guidelines by using the recommended Vt and PEEP. Since the benefits of having protocols are well established in the literature, there is room for improvement in the use of protocols for mechanical ventilation of patients with ARDS/ALI. Sponsored Research - None

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