Provider Bias Impacts Tidal Volume Selection and Ventilator Days in Trauma Patients

Collier, Bryan R.; Vieau, Chris; Lockhart, Ellen Rachel; Bradburn, Eric H.; Hamill, Mark E.; Love, Katie M.; Reed, Chris D.; Baker, Christopher C.

doi:10.1016/j.jamcollsurg.2015.12.045

Cited by 2 publications

(2 citation statements)

References 17 publications

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“…(3) Secondary outcomes of interest included the timing of ARDS, the presence and timing of hypoxemia during days 1-7 as defined by a P/F ratio ≤ 300 mmHg without chest imaging requirements, the lowest P/F ratio on day 1 and days 1-7, the timing of ventilator liberation, and ventilator-free days within 30 days. (14, 18, 19) Ventilator-free days within 30 days are the number of days alive and without mechanical ventilation within the first 30 days of care. As such, those that die while receiving mechanical ventilation are assigned a value of zero ventilator-free days.…”

Section: Methodsmentioning

confidence: 99%

Risk Factors for the Development of Acute Respiratory Distress Syndrome Following Hemorrhage

Robinson

Cohen

Holcomb

et al. 2018

Shock

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Section: Methodsmentioning

confidence: 99%

Risk Factors for the Development of Acute Respiratory Distress Syndrome Following Hemorrhage

Robinson

Cohen

Holcomb

et al. 2018

Shock

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“…Pulmonary ventilation, controlled by volume rather than pressure, might modify the rate of postoperative pulmonary complications, even though studies in patients with acute lung injury have not shown significant differences . Postoperative pulmonary complications are associated with intra‐operative PEEP, ventilatory driving pressure and oxygen partial pressure . Studies have reported effects of pressure‐controlled vs. volume‐controlled intra‐operative ventilation on physiological variables but not clinical pulmonary outcomes .…”

Section: Introductionmentioning

confidence: 99%

The association of postoperative pulmonary complications in 109,360 patients with pressure‐controlled or volume‐controlled ventilation

Bagchi

Rudolph

et al. 2017

Anaesthesia

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We thought that the rate of postoperative pulmonary complications might be higher after pressure-controlled ventilation than after volume-controlled ventilation. We analysed peri-operative data recorded for 109,360 adults, whose lungs were mechanically ventilated during surgery at three hospitals in Massachusetts, USA. We used multivariable regression and propensity score matching. Postoperative pulmonary complications were more common after pressure-controlled ventilation, odds ratio (95%CI) 1.29 (1.21-1.37), p < 0.001. Tidal volumes and driving pressures were more varied with pressure-controlled ventilation compared with volume-controlled ventilation: mean (SD) variance from the median 1.61 (1.36) ml.kg vs. 1.23 (1.11) ml.kg , p < 0.001; and 3.91 (3.47) cmH O vs. 3.40 (2.69) cmH O, p < 0.001. The odds ratio (95%CI) of pulmonary complications after pressure-controlled ventilation compared with volume-controlled ventilation at positive end-expiratory pressures < 5 cmH O was 1.40 (1.26-1.55) and 1.20 (1.11-1.31) when ≥ 5 cmH O, both p < 0.001, a relative risk ratio of 1.17 (1.03-1.33), p = 0.023. The odds ratio (95%CI) of pulmonary complications after pressure-controlled ventilation compared with volume-controlled ventilation at driving pressures of < 19 cmH O was 1.37 (1.27-1.48), p < 0.001, and 1.16 (1.04-1.30) when ≥ 19 cmH O, p = 0.011, a relative risk ratio of 1.18 (1.07-1.30), p = 0.016. Our data support volume-controlled ventilation during surgery, particularly for patients more likely to suffer postoperative pulmonary complications.

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Provider Bias Impacts Tidal Volume Selection and Ventilator Days in Trauma Patients

Cited by 2 publications

References 17 publications

Risk Factors for the Development of Acute Respiratory Distress Syndrome Following Hemorrhage

Risk Factors for the Development of Acute Respiratory Distress Syndrome Following Hemorrhage

The association of postoperative pulmonary complications in 109,360 patients with pressure‐controlled or volume‐controlled ventilation

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