• Peter Luedike, Matthias Totzeck, Christos Rammos, Detlef Kindgen-Milles, Malte Kelm, and Tienush Rassaf.
• Division of Cardiology, Pulmonology and Vascular Medicine, Medical Faculty Heinrich-Heine-University, University Hospital Duesseldorf, Moorenstrasse 5, D-40225, Duesseldorf, Germany.
• J Crit Care. 2015 Oct 1; 30 (5): 1114-8.

PurposeMortality in acute respiratory distress syndrome (ARDS) patients remains unacceptable high, and there is substantial variation in the diagnostic and management strategies used. We recently established a standardized algorithm for the early identification and guideline conform therapy of ARDS on intensive care units (ICUs). We here present the results of a first-year observatory period after implementation of the ARDS bundle on our ICU.Methods And ResultsA retrospective, observative, single-center case control study over a period of 4 years was performed. We analyzed the effects after implementation of an ARDS standard operating procedure (SOP) on prevalence of the diagnosis ARDS, mortality from ARDS, and therapy strategies. Implementation of the SOP led to an increased frequency of ARDS diagnosis (P < .05), increased application of early prone positioning (P < .05), and use of neuromuscular blockers (P < .02) in ARDS patients. An influence on mortality in ARDS patients could not be detected after implementation of the SOP (P = not significant).ConclusionA standardized ARDS bundle fundamentally increases awareness of this clinical picture on ICU and facilitates application of evidence-based therapies like prone positioning and use of neuromuscular blockers. These data encourage evaluating our ARDS SOP in a prospective trial to identify potential effects on mortality.Copyright © 2015 Elsevier Inc. All rights reserved.

21 keywords...

hide…