• Michael W Sjoding.
• aDepartment of Internal Medicine, Pulmonary and Critical Care Medicine bInstitute for Healthcare Policy & Innovation, Michigan Center for Integrated Research in Critical Care, University of Michigan, Ann Arbor, Michigan, USA.
• Curr Opin Crit Care. 2017 Oct 1; 23 (5): 406-411.

Purpose Of ReviewAlthough the treatment of the acute respiratory distress syndrome (ARDS) with low tidal volume (LTV) mechanical ventilation improves mortality, it is not consistently administered in clinical practice. This review examines strategies to improve LTV and other evidence-based therapies for patients with ARDS.Recent FindingsDespite the well established role of LTV in the treatment of ARDS, a recent multinational study suggests it is under-utilized in clinical practice. Strategies to improve LTV include audit and feedback, provider education, protocol development, interventions to improve ICU teamwork, computer decision support, and behavioral economic interventions such as making LTV the default-ventilator setting. These strategies typically target all patients receiving invasive mechanical ventilation, effectively avoiding the problem of poor ARDS recognition in clinical practice. To more effectively administer advanced ARDS therapies, such as prone positioning, better approaches for ARDS recognition will also be required.SummaryMultiple strategies can be utilized to improve adherence to LTV ventilation in ARDS patients.

13 keywords...

hide…