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A 5-year observational study of lung-protective ventilation in the operating room: A single-center experience.
MedLine Citation:
PMID:  23369521     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
PURPOSE: We assessed the evolution of lung-protective ventilation strategies during anesthesia and identified factors associated with the selection of a nonprotective ventilation strategy. METHODS: This retrospective observational study covered a 5-year period from March 2006 to March 2011. It included 45 575 adult patients who underwent intubation de novo in the operating room. We considered a tidal volume (V(T)) greater than 10 mL/kg of ideal body weight (IBW) and/or positive end-expiratory pressure (PEEP) less than 5 cm H(2)O as not lung protective. We evaluated the use of nonprotective ventilation strategies over time in men and women, by American Society of Anesthesiologists classification, and for elective vs emergent surgery. RESULTS: Over the duration of the study, there was a significant reduction in the percentage of patients receiving a V(T) greater than 10 mL/kg IBW (28.5%-16.3%, P < .001), zero PEEP (27.5%-18.2%, P < .001), and V(T) greater than 10 mL/kg IBW with PEEP less than 5 cm H(2)O (13.4%-8.0%, P < .001). The odds of receiving nonprotective ventilation were greater for women than for men, in the first year compared with the last year, and for elective compared with emergent surgery. CONCLUSION: Although use of nonprotective ventilation decreased over time, an important percentage of patients continue to receive nonprotective ventilation.
Authors:
Dean R Hess; Dhimiter Kondili; Edward Burns; Edward A Bittner; Ulrich H Schmidt
Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2013-1-29
Journal Detail:
Title:  Journal of critical care     Volume:  -     ISSN:  1557-8615     ISO Abbreviation:  J Crit Care     Publication Date:  2013 Jan 
Date Detail:
Created Date:  2013-2-1     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8610642     Medline TA:  J Crit Care     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
Copyright © 2012 Elsevier Inc. All rights reserved.
Affiliation:
Respiratory Care, Massachusetts General Hospital, Harvard Medical School, Boston, MA 02114. Electronic address: dhess@partners.org.
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