Ventilation management in Victorian intensive care unit patients without acute respiratory distress syndrome

Christopher T. Eyeington, Neil J. Glassford, Jai Darvall, Andrew Casamento, Tim Haydon, Gopal Taori, Cameron Knott, Forbes McGain, Joseph Vetro, Nick Simpson, Vineet Sarode, Angus Richardson, Charles Dunnachie, Marco Crisman, Jason Musci, Nicholas Woinarski, Rohan Lynham, Glenn M. Eastwood, Rinaldo Bellomo, Dharshi Karalapillai

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3 Citations (Scopus)

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 (PaCO2) management where hypercapnia was potentially physiologically contraindicated. Results: We recorded 453 observational sets in 123 patients across seven ICUs. The most commonly selected initial Twas 500 mL (33%), and this proportion did not differ according to sex (32% male, 34% female). Moreover, 38% of patients were exposed to initial VTper predicted body weight (VT-PBW) > 8.0 mL/kg. T-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 PaCO2and higher pH. Conclusions: In adults without ARDS undergoing CMV in Australian ICUs, the initial Twas a stereotypical 500 mL in one-third of participants, irrespective of sex. Moreover, around 40% of patients were exposed to an initial T-PBW > 8.0 mL/kg. Finally, women were more likely to be exposed to a high Tand hyperventilation.

Original languageEnglish
Pages (from-to)101-108
Number of pages8
JournalCritical Care and Resuscitation
Volume20
Issue number2
Publication statusPublished - 1 Jun 2018

Cite this

Eyeington, C. T., Glassford, N. J., Darvall, J., Casamento, A., Haydon, T., Taori, G., Knott, C., McGain, F., Vetro, J., Simpson, N., Sarode, V., Richardson, A., Dunnachie, C., Crisman, M., Musci, J., Woinarski, N., Lynham, R., Eastwood, G. M., Bellomo, R., & Karalapillai, D. (2018). Ventilation management in Victorian intensive care unit patients without acute respiratory distress syndrome. Critical Care and Resuscitation, 20(2), 101-108.