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VOLUME 18 , ISSUE 11 ( November, 2014 ) > List of Articles

BRIEF COMMUNICATION

A complete audit cycle to assess adherence to a lung protective ventilation strategy

Emma Joynes, Satinder Dalay, Jaimin Patel, Samia Fayek

Keywords : Intensive care, protective, respiratory, tidal volume, ventilation

Citation Information : Joynes E, Dalay S, Patel J, Fayek S. A complete audit cycle to assess adherence to a lung protective ventilation strategy. Indian J Crit Care Med 2014; 18 (11):746-749.

DOI: 10.4103/0972-5229.144020

License: CC BY-ND 3.0

Published Online: 00-11-2014

Copyright Statement:  Copyright © 2014; Jaypee Brothers Medical Publishers (P) Ltd.


Abstract

There is clear evidence for the use of a protective ventilation protocol in patients with acute respiratory distress syndrome (ARDS). There is evidence to suggest that protective ventilation is beneficial in patients at risk of ARDS. A protective ventilation strategy was implemented on our intensive care unit in critical care patients who required mechanical ventilation for over 48 h, with and at risk for ARDS. A complete audit cycle was performed over 13 months to assess compliance with a safe ventilation protocol in intensive care. The ARDS network mechanical ventilation protocol was used as the standard for our protective ventilation strategy. This recommends ventilation with a tidal volume (Vt ) of 6 ml/kg of ideal body weight (IBW) and plateau airway pressure of ≤30 cm H 2 O. The initial audit failed to meet this standard with Vt ′s of 9.5 ml/kg of IBW. Following the implementation of a ventilation strategy and an educational program, we demonstrate a significant improvement in practice with Vt ′s of 6.6 ml/kg of IBW in the re-audit. This highlights the importance of simple interventions and continuous education in maintaining high standards of care.


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