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Title: Ventilation management in Victorian intensive care unit patients without acute respiratory distress syndrome.
Author: Eyeington, Christopher T.
Glassford, Neil J.
Casamento, Andrew
Haydon, Tim
Taori, Gopal
Knott, Cameron
McGain, Forbes
Vetro, Joseph
Simpson, Nick
Sarode, Vineet
Richardson, Angus
Dunnachie, Charles
Crisman, Marco
Musci, Jason
Woinarski, Nicholas
Lynham, Rohan
Eastwood, Glenn M
Bellomo, Rinaldo
Karalapillai, Dharshi
Issue Date: 2018
Publication Title: Critical Care and Resuscitation
Volume: 20
Issue: 2
Start Page: 101
End Page: 108
Abstract: BACKGROUND: The setting of tidal volume (VT) during controlled mechanical ventilation (CMV) in critically ill patients without acute respiratory distress syndrome (ARDS) is likely important but currently unknown. We aimed to describe current CMV settings in intensive care units (ICUs) across Victoria. METHODS: We performed a multicentre, prospective, observational study. We collected clinical, ventilatory and arterial blood gas data twice daily for 7 days. We performed subgroup analysis by sex and assessment of arterial partial pressure of carbon dioxide (PaCO<inf>2</inf>) management where hypercapnia was potentially physiologically contraindicated. RESULTS: We recorded 453 observational sets in 123 patients across seven ICUs. The most commonly selected initial V<inf>T</inf> was 500 mL (33%), and this proportion did not differ according to sex (32% male, 34% female). Moreover, 38% of patients were exposed to initial V<inf>T</inf> per predicted body weight (V<inf>T</inf>-PBW) > 8.0 mL/kg. V<inf>T</inf>-PBW in this range were more likely to occur in females, those with a lower height, lower ideal body weight or in those for whom hypercapnia was potentially physiologically contraindicated. As a consequence, females were more frequently exposed to a lower PaCO<inf>2</inf> and higher pH. CONCLUSIONS: In adults without ARDS undergoing CMV in Australian ICUs, the initial V<inf>T</inf> was a stereotypical 500 mL in one-third of participants, irrespective of sex. Moreover, around 40% of patients were exposed to an initial V<inf>T</inf>-PBW > 8.0 mL/kg. Finally, women were more likely to be exposed to a high V<inf>T</inf> and hyperventilation.
ISSN: 1441-2772
Internal ID Number: 01186
Type: Journal Article
Appears in Collections:Research Output

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