The Science Journal of the American Association for Respiratory Care

2011 OPEN FORUM Abstracts

PATTERNS OF TIDAL VOLUME DELIVERY DURING MECHANICAL VENTILATION: A RETROSPECTIVE REVIEW OF 2004-2010.

Carl Haas, Mark Konkle, Allan Andrews, Kimberly Bauser, Ric Eakin, Sue Henning, Paul Loik; UH Respiratory Care, Univ of Michigan Health System, Ann Arbor, MI

BACKGROUND: It has been shown that VT and Pplat limitation can improve mortality in ALI/ARDS patients and it has been suggested that these settings may influence causation of lung injury in patients without lung injury. STUDY OBJECTIVES: To determine: 1) tidal volume dose (mL/kg PBW), 2) VT vs Pplat relationship, and 3) PEEP levels used over a 7-year period. METHODS: A retrospective review of a department database from 2004 through 2010. Data included patient gender and height, ventilator settings, and airway pressures. PBW was calculated from ARDSnet formulas and used to express VT in mL/kg of PBW. Data from the first full day of MV was analyzed. RESULTS: Mean VT decreased each year. Mean VT for all 6 ICU's was < 10 mL for 50% in 2004, < 9 mL/kg for 83% in 2007 and < 8 mL/kg for 83% in 2010. Females were consistently ventilated with larger VTs than males by 8-13%. Mean Pplat remained relatively constant. PEEP levels increased slightly each year; only 5% of patients had < 8 cmH2O on day-1 in 2004 vs < 20% from 2007-2010. The % of patient with VT < 10 mL/kg & Pplat < 30 increased each year. CONCLUSION: VT declined each year. To help ensure clinician awareness of the specific VT delivered, therapists are required to chart VT in mL/kg of PBW. We are moving to computerized ventilator documentation where this value is auto-calculated.
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