Best practices for ventilator management in patients with the acute respiratory distress syndrome (ARDS) have been outlined by the scientific literature. But out in the real world, they aren’t always followed.
A new study out of the Mayo Clinic finds an RT-driven order set can turn that situation around, and AARC member Verlin Weber, BS, RRT, is among the authors.
The study was conducted among 1,302 patients representing 1,693 separate episodes of invasive mechanical ventilation who were treated before and after initiation of the RT-driven order set. Physician-specified lung-protective ventilation and oxygenation goals implemented by RTs included Pao2, ARDS Network PEEP/Fio2 table use, pH, and partial pressure of carbon dioxide.
Results showed an 88.2% compliance with the new mechanical ventilator order set vs. 3.8% compliance with best practices prior to implementation. Following implementation, adherence to the PEEP/Fio2 table rose from 82.9% to 86.0%. Duration of mechanical ventilation, ICU length of stay, and in-hospital and ICU mortality were unchanged.
Weber and his colleagues concluded: “A standardized best practice mechanical ventilation order set can be implemented by a multidisciplinary team and is associated with improved compliance to written orders and adherence to the ARDSNet PEEP/Fio2 table.”
The study was published online ahead of print by the Journal of Intensive Care Medicine on Dec. 5, 2017.
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