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Intraoperative adherence to a low tidal volume ventilation strategy in critically ill patients with preexisting acute lung injury.

Abstract：

PURPOSE:Low tidal volume (LTV) ventilation reduces mortality in patients with acute lung injury (ALI) or acute respiratory distress syndrome (ARDS). This study investigates adherence of intraoperative LTV and whether patient outcomes were different with or without continued intraoperative LTV ventilation in patients with previously established ALI or ARDS. MATERIALS AND METHODS:A retrospective analysis was performed of adults with ALI/ARDS over a 2-year period who underwent surgery between 24 hours and 14 days after the diagnosis of ALI/ARDS. The main outcome was intraoperative LTV use. Secondary outcomes included perioperative respiratory and clinical outcomes. RESULTS:Of the 249 patients who underwent surgery between 24 hours and 14 days after ALI/ARDS diagnosis, 101 (41%) received preoperative LTV ventilation. Fifty-four (53%) received intraoperative LTV ventilation, whereas 47 (47%) did not. Use of preoperative LTV ventilation was associated with use of intraoperative LTV ventilation (P < .01). No differences in respiratory or clinical outcomes between patients with or without intraoperative LTV ventilation were observed. CONCLUSIONS:Adherence to intraoperative LTV in surgical patients was low. Adherence of LTV intraoperatively was not associated with improved oxygenation, reductions in hospital length of stay, or in-hospital mortality. The importance of adhering to an intraoperative LTV strategy remains unclear.

journal_name

J Crit Care

journal_title

Journal of critical care

authors

Chaiwat O,Vavilala MS,Philip S,Malakouti A,Neff MJ,Deem S,Treggiari MM,Wang J,Lang JD

doi

10.1016/j.jcrc.2010.08.002

subject

Has Abstract

pub_date

2011-04-01 00:00:00

pages

144-51

issue

2

eissn

0883-9441

issn

1557-8615

pii

S0883-9441(10)00218-2

journal_volume

26

pub_type

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