Intraoperative adherence to a low tidal volume ventilation strategy in critically ill patients with preexisting acute lung injury

Onuma Chaiwat, Monica S. Vavilala, Shaji Philip, Amin Malakouti, Margaret J. Neff, Steven Deem, Miriam Treggiari, Jin Wang, John D. Lang

Research output: Contribution to journalArticle

13 Citations (Scopus)

Abstract

Purpose: Low tidal volume (LTV) ventilation reduces mortality in patients with acute lung injury (ALI) or acute respiratory distress syndrome (ARDS). This study investigates adherence of intraoperative LTV and whether patient outcomes were different with or without continued intraoperative LTV ventilation in patients with previously established ALI or ARDS. Materials and Methods: A retrospective analysis was performed of adults with ALI/ARDS over a 2-year period who underwent surgery between 24 hours and 14 days after the diagnosis of ALI/ARDS. The main outcome was intraoperative LTV use. Secondary outcomes included perioperative respiratory and clinical outcomes. Results: Of the 249 patients who underwent surgery between 24 hours and 14 days after ALI/ARDS diagnosis, 101 (41%) received preoperative LTV ventilation. Fifty-four (53%) received intraoperative LTV ventilation, whereas 47 (47%) did not. Use of preoperative LTV ventilation was associated with use of intraoperative LTV ventilation (P <.01). No differences in respiratory or clinical outcomes between patients with or without intraoperative LTV ventilation were observed. Conclusions: Adherence to intraoperative LTV in surgical patients was low. Adherence of LTV intraoperatively was not associated with improved oxygenation, reductions in hospital length of stay, or in-hospital mortality. The importance of adhering to an intraoperative LTV strategy remains unclear.

Original languageEnglish (US)
Pages (from-to)144-151
Number of pages8
JournalJournal of Critical Care
Volume26
Issue number2
DOIs
StatePublished - Apr 2011
Externally publishedYes

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Acute Lung Injury
Tidal Volume
Critical Illness
Adult Respiratory Distress Syndrome
Ventilation
Length of Stay
Hospital Mortality

Keywords

  • ALI
  • Anesthesia
  • ARDS
  • Intraoperative
  • Low tidal volume
  • Lung injury
  • Mechanical ventilation

ASJC Scopus subject areas

  • Critical Care and Intensive Care Medicine

Cite this

Intraoperative adherence to a low tidal volume ventilation strategy in critically ill patients with preexisting acute lung injury. / Chaiwat, Onuma; Vavilala, Monica S.; Philip, Shaji; Malakouti, Amin; Neff, Margaret J.; Deem, Steven; Treggiari, Miriam; Wang, Jin; Lang, John D.

In: Journal of Critical Care, Vol. 26, No. 2, 04.2011, p. 144-151.

Research output: Contribution to journalArticle

Chaiwat, Onuma ; Vavilala, Monica S. ; Philip, Shaji ; Malakouti, Amin ; Neff, Margaret J. ; Deem, Steven ; Treggiari, Miriam ; Wang, Jin ; Lang, John D. / Intraoperative adherence to a low tidal volume ventilation strategy in critically ill patients with preexisting acute lung injury. In: Journal of Critical Care. 2011 ; Vol. 26, No. 2. pp. 144-151.
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