Evaluation of an intervention to reduce tidal volumes in ventilated ICU patients

Bourdeaux, C. P.; Birnie, K.; Trickey, A.; Thomas, M. J.C.; Sterne, J.; Donovan, J. L.; Benger, Jonathan; Brandling, J.; Gould, T. H.

Abstract

Background
There is considerable evidence that the use of tidal volumes < 6 ml kg?1 predicted body weight (PBW) reduces mortality in mechanically ventilated patients. We evaluated the effectiveness of using a large screen displaying delivered tidal volume in ml kg?1 (PBW) for reducing tidal volumes.

Methods
We assessed the intervention in two 6-month periods. A qualitative study was undertaken after the intervention period to examine staff interaction with the intervention. The study was conducted in a mixed medical and surgical intensive care unit at University Hospitals Bristol, UK. Consecutive patients requiring controlled mechanical ventilation for more than 1 h were included. Alerts were triggered when tidal volume breached predetermined targets and these alerts were visible to ICU clinicians in real time.

Results
A total of 199 patients with 7640 h of data were observed during the control time period and 249 patients with 10 656 h of data were observed in the intervention period. Time spent with tidal volumes

Citation

Bourdeaux, C. P., Birnie, K., Trickey, A., Thomas, M. J., Sterne, J., Donovan, J. L., …Gould, T. H. (2015). Evaluation of an intervention to reduce tidal volumes in ventilated ICU patients. British Journal of Anaesthesia, 115(2), 244-251. https://doi.org/10.1093/bja/aev110

• Journal Article Type: Article
• Publication Date: Aug 1, 2015
• Journal: British Journal of Anaesthesia
• Print ISSN: 0007-0912
• Electronic ISSN: 1471-6771
• Publisher: Elsevier
• Peer Reviewed: Peer Reviewed
• Volume: 115
• Issue: 2
• Pages: 244-251
• DOI: https://doi.org/10.1093/bja/aev110
• Keywords: acute respiratory distress syndrome, behavioural economics, computerised decision support systems, lung protective ventilation, quality improvement
• Public URL: https://uwe-repository.worktribe.com/output/834958
• Publisher URL: http://dx.doi.org/10.1093/bja/aev110