Ventilator settings and monitoring parameter targets for initiation of continuous mandatory ventilation: a questionnaire study

Journal of Critical Care
Louise RoseSangeeta Mehta

Abstract

To inform development of educational tools, we sought to identify initial ventilator settings and monitoring targets for 3 scenarios. A survey was e-mailed to Canadian Society of Respiratory Therapists members with 2 reminders in March/April 2011. Total evaluable surveys were 363. More participants selected pressure as opposed to volume ventilation for acute respiratory distress syndrome (ARDS; 77%) than for chronic obstructive pulmonary disease (COPD; 50%) and postoperative ventilation (32%; P < .001). Mean tidal volume was lower for ARDS than for COPD and postoperative ventilation (5.7, 6.9, and 7.2 mL/kg, respectively; P < .001). Maximum acceptable plateau pressures were highest for ARDS (30 cm H2O vs 29 cm H2O [COPD] and 27 cm H2O [postoperative], P < .001). Initial positive expiratory end pressure (12 cm H2O vs 7 cm H2O vs 5 cm H2O) and fraction of inspired oxygen (Fio2; 1.0 vs 0.5 vs 0.3) were also higher for ARDS (both P < .001); however, only 8% selected a positive expiratory end pressure/Fio2 combination as recommended by ARDSnet. Values of oxygen saturation as measured by pulse oximetry of 97% (ARDS) and 94% (COPD and postoperative) were considered appropriate for Fio2 reduction. The lowest pH was 7.28 vs 7.23 vs 7.26...Continue Reading

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Citations

Dec 17, 2014·Current Opinion in Critical Care·Ary Serpa NetoMarcus J Schultz
Aug 6, 2015·The Journal of Pharmacology and Experimental Therapeutics·Mark J MondrinosLaurie E Kilpatrick
Jun 24, 2015·Current Opinion in Critical Care·Marcus J SchultzPaolo Pelosi

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