P241 Validation of APPS tool to predict mortality in moderate and severe acute respiratory distress syndrome

Jayaschandran, Vivek; Schuiteman, Emily; Otoupalova, Eva; Ginoya, Sonal Kaushal; Boura, Judy; Dalal, Bhavinkumar

doi:10.1016/j.chest.2017.04.148

Cited by 2 publications

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“…This is the first study to demonstrate the impact of an ED-ICU on LPV adherence. Notably, the EC3 cohort had a lower incidence of severe hyperoxia and a 92.8% adherence rate to low Vt ventilation, which is significantly higher compared with previously reported data from other ED and ICU settings (3,4,(10)(11)(12)(35)(36)(37)(38). Since ED ventilator settings are frequently continued on ICU admission, these early ventilator adjustments are vital for continued highquality care.…”

Section: Discussionmentioning

confidence: 74%

Initiation of a Lung Protective Ventilation Strategy in the Emergency Department: Does an Emergency Department-Based ICU Make a Difference?

Harvey

Haas²,

Chen

et al. 2022

Critical Care Explorations

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BACKGROUND: Lung protective ventilation (LPV) is a key component in the management of acute respiratory distress syndrome and other acute respiratory pathology. Initiation of LPV in the emergency department (ED) is associated with improved patient-centered and system outcomes, but adherence to LPV among ED patients is low. The impact of an ED-based ICU (ED-ICU) on LPV adherence is not known. METHODS: This single-center, retrospective, cohort study analyzed rates of adherence to a multifaceted LPV strategy pre- and post-implementation of an ED-ICU. LPV strategy components included low tidal volume ventilation, avoidance of severe hyperoxia and high plateau pressures, and positive end-expiratory pressure settings in alignment with best-evidence recommendations. The primary outcome was adherence to the LPV strategy at time of ED departure. RESULTS AND CONCLUSIONS: A total of 561 ED visits were included in the analysis, of which 60.0% received some portion of their emergency care in the ED-ICU. Adherence to the LPV strategy was statistically significantly higher in the ED-ICU cohort compared with the pre-ED-ICU cohort (65.8% vs 41.4%; p < 0.001) and non-ED-ICU cohort (65.8% vs 43.1%; p < 0.001). Among the ED-ICU cohort, 92.8% of patients received low tidal volume ventilation. Care in the ED-ICU was also associated with shorter ICU and hospital length of stay. These findings suggest improved patient and resource utilization outcomes for mechanically ventilated ED patients receiving care in an ED-ICU.

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Section: Discussionmentioning

confidence: 74%

Initiation of a Lung Protective Ventilation Strategy in the Emergency Department: Does an Emergency Department-Based ICU Make a Difference?

Harvey

Haas²,

Chen

et al. 2022

Critical Care Explorations

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show abstract

“…In this issue of Current COVID-19 has also helped us think about how to better deliver care to a broad range of critically ill patients. Despite convincing evidence of its benefits, we know adoption of low-tidal volume ventilation for ARDS was poor prior to the pandemic [4]. And, anecdotally, use of prone positioning was similarly sparse in many units despite high-quality data supporting its benefit.…”

mentioning

confidence: 99%

Editorial: Critical care outcomes in the context of a pandemic

Gershengorn

2021

Current Opinion in Critical Care

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P241 Validation of APPS tool to predict mortality in moderate and severe acute respiratory distress syndrome

Cited by 2 publications

References 0 publications

Initiation of a Lung Protective Ventilation Strategy in the Emergency Department: Does an Emergency Department-Based ICU Make a Difference?

Initiation of a Lung Protective Ventilation Strategy in the Emergency Department: Does an Emergency Department-Based ICU Make a Difference?

Editorial: Critical care outcomes in the context of a pandemic

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