Abstract
Background:
Ventilator-associated lung injury is highly associated with the tidal volume (VT) selection, which requires special attention and monitoring in an ICU. 1 The current guidelines recommend setting the VT according to the ideal body weight (IBW).18-19 However, there is a lack of research that examines the adherence of clinical practitioners to the ideal method of setting the VT for patients who require mechanical ventilation. The aim of this study is to explore whether the selection of VT in mechanically ventilated patients is based on patients’ IBW.
Methods:
Cross sectional study was conducted at King Abdulaziz Medical City during the period 2016-2018. Electronic medical records were used to extract the information on all intubated adult patients who had been admitted to the ICUs. From each medical record, demographic information, clinical diagnosis, and ventilator settings were extracted. We compared the set VT that each patient received with the adjusted VT based on IBW.
Results:
A total of 160 patients were admitted to the ICU and received mechanical ventilation during the study period. The mean age of the included patients was 66 (SD=18 years), and the majority were male patients (53%). One hundred thirty-five (84%) of the patients were diagnosed with restrictive pulmonary disease, and the average set VT was 378 (SD=57 mL). Twenty-five patients (15%) were diagnosed with obstructive pulmonary disease with mean of set VT 361 (SD=70 mL). After calculating the adjusted VT, 59% of the patients received volume out of the appropriate range.
Conclusions:
This study shows that set VT by Respiratory Therapist (RT) for patients receiving mechanical ventilation is inconsistent with the predicted VT based on ideal body weight with a P value < 0.001. This provides evidence to improve the current practices of setting VT parameters.
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