Use of low tidal volume ventilation in the emergency departments: retrospective multicenter observational study
- Author:
Keun Ho KIM
1
;
Ji-Hoon KIM
;
Youngmin OH
;
Sung Wook KIM
;
Kyungman CHA
;
Gyeong Nam PARK
;
Hwan SONG
;
June Young LEE
;
Seon Yeong PARK
Author Information
1. Department of Emergency Medicine, College of Medicine, The Catholic University of Korea, Seoul, Korea
- Publication Type:Original Article
- From:Journal of the Korean Society of Emergency Medicine
2022;33(4):397-405
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
Objective:Low tidal volume ventilation (LTVV) is one of the strategies to prevent ventilator-induced lung injuries. This study aimed to investigate the use of LTVV among endotracheally intubated patients who received mechanical ventilation (MV) in emergency departments (EDs).
Methods:We conducted a retrospective, standardized chart review of all adult patients who received MV in 6 EDs between July 2020 and June 2021. The data of a total of 766 patients who had an initial application of MV in the ED were analyzed. The primary outcome was exhaled tidal volume. Logistic regression analyses were conducted to develop a multivariate model identifying the factors associated with conventional tidal volume ventilation (CTVV), defined as the exhaled tidal volume of >8 mL/kg predicted body weight.
Results:Of the 766 patients, 483 patients (62.8%) were male. Respiratory failure (37.8%) was the most common indication for MV. In the initial ventilator setting, pressure control ventilation was preferred to volume control ventilation (80.4% vs. 19.0%). LTVV was used in 418 patients (54.6%). In the multivariate logistic regression analysis, the factors associated with the CTVV were female sex (adjusted odds ratio [OR], 2.62; 95% confidence interval [CI], 1.03-6.69), height (adjusted OR, 0.92; 95% CI, 0.89-0.94), and respiratory rate (adjusted OR, 0.93; 95% CI, 0.87-0.99).
Conclusion:About half of the adult patients undergoing MV received LTVV in the ED. The female sex, height, and respiratory rate were associated with CTVV. The use of predicted body weight based on sex could increase the usage of LTVV.
