Respiratory failure & ventilation
The Practice Change and Clinical Impact of Lung-Protective Ventilation Initiated in the Emergency Department: A Secondary Analysis of Individual Patient-Level Data From Prior Clinical Trials and Cohort Studies*
Primary result · Tidal volume (primary ventilator-related outcome) and hospital mortality (primary clinical outcome)Result — go to the resultAdjusted odds ratio 0.43 95% CI 0.35–0.53Authors' conclusion
ED lung-protective ventilation has persisted in the years since implementation and was associated with improved outcomes.
Study context
- Population
- Mechanically ventilated adults, emergency department (ED) and ICUs of a single academic center
- Participants
- 1,403 vs 1,796
- Comparison
- ED lung-protective ventilator protocol vs preintervention period
- Intervention periodn = 1,403
- Preintervention periodn = 1,796reference
- Primary endpoint
- Tidal volume (primary ventilator-related outcome) and hospital mortality (primary clinical outcome)
Methodological detailssingle-centre, before-after (preintervention vs intervention period), multivariable logistic regression, propensity score adjustment, a priori subgroup analyses
- Single-centre
- Before-after (preintervention vs intervention period)
- Multivariable logistic regression
- Propensity score adjustment
- A priori subgroup analyses
Primary result
As reported in the abstract
Adjusted odds ratio
0.43
95% CI 0.35–0.53
P < 0.01
By group
Preintervention period
8.2
spread (unnamed) 7.3–9.1 · mL/kg predicted body weight (PBW)
Intervention period
6.5
spread (unnamed) 6.1–7.1 · mL/kg PBW
Preintervention period
35.9%
Intervention period
19.1%
Intervention period vs Preintervention period
aOR 0.43 (95% CI 0.35–0.53); P < 0.01
- Tidal volume reduced and low tidal volume ventilation increased in the intervention period
- P < 0.01
Secondary outcomes
| Outcome | P value |
|---|---|
| Ventilator-free days | P < 0.01 |
| Hospital-free days | P < 0.01 |
| ICU-free days | P < 0.01 |
Parts of this Brief are withheld: the automatic checks could not confirm them against the abstract.
Original publication
The Practice Change and Clinical Impact of Lung-Protective Ventilation Initiated in the Emergency Department: A Secondary Analysis of Individual Patient-Level Data From Prior Clinical Trials and Cohort Studies*. Crit Care Med. Published 14 November 2022. doi:10.
Composed by AI from the published abstract and checked against it. How Briefs are made →