ArticleCritical care medicine2017
A Quasi-Experimental, Before-After Trial Examining the Impact of an Emergency Department Mechanical Ventilator Protocol on Clinical Outcomes and Lung-Protective Ventilation in Acute Respiratory Distress Syndrome.
Article in Critical care medicine, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 23 papers, 1 of them a synthesis that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
23 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Evolution of Acute Respiratory Distress Syndrome in Emergency and Critical Care: Therapeutic Management before and during the Pandemic Situation.Medicina (Kaunas, Lithuania) · 2022Pooled it
- Management of Mechanical Ventilation in Emergency Medicine: A Scoping Review.Journal of the American College of Emergency Physicians open · 2026Review
- Noninvasive respiratory support in the emergency department: Controversies and state-of-the-art recommendations.Journal of the American College of Emergency Physicians open · 2024Review
- A dual-center cohort study on the association between early deep sedation and clinical outcomes in mechanically ventilated patients during the COVID-19 pandemic: The COVID-SED study.Critical care (London, England) · 2022Article
- Mechanical Ventilation Practices and Low Tidal Volume Ventilation in Air Medical Transport Patients: The AIR-VENT Study.Respiratory care · 2022Article
- A Dual-Center Cohort Study on The Association Between Early Deep Sedation and Clinical Outcomes in Mechanically Ventilated Patients During the COVID-19 Pandemic: the COVID-SED Study.Research square · 2022Article
- Initiation of a Lung Protective Ventilation Strategy in the Emergency Department: Does an Emergency Department-Based ICU Make a Difference?Critical care explorations · 2022Article
- A Target for Increased Mortality Risk in Critically Ill Patients: The Concept of Perpetuity.Journal of clinical medicine · 2021Article
- Adherence to Lung Protective Ventilation in Patients With Coronavirus Disease 2019.Critical care explorations · 2021Article
- Patient characteristics and outcomes associated with adherence to the low PEEP/FIO2 table for acute respiratory distress syndrome.Scientific reports · 2021Article
- Emergency Department Management of Severe Hypoxemic Respiratory Failure in Adults With COVID-19.The Journal of emergency medicine · 2021Review
- Promoting Evidence-Based Practice in Acute Respiratory Distress Syndrome: A Systematic Review.Critical care explorations · 2021Review
- Article
- Effectiveness of simulation based teaching of ventilatory management among non-anaesthesiology residents to manage COVID 19 pandemic - A Quasi experimental cross sectional pilot study.Indian journal of anaesthesia · 2020Article
- Observational
- The effect of emergency department crowding on lung-protective ventilation utilization for critically ill patients.Journal of critical care · 2019Observational
- Invasive mechanical ventilation in the emergency department.Turkish journal of emergency medicine · 2019Review
- Ventilator for the treatment of acute respiratory distress syndrome: A protocol for systematic review and meta-analysis.Medicine · 2018Article
- The basics of respiratory mechanics: ventilator-derived parameters.Annals of translational medicine · 2018Review
- Thirty-day hospital readmissions among mechanically ventilated emergency department patients.Emergency medicine journal : EMJ · 2018Observational
Corrections and comments
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Authors and funding
13 authors.
Funding
Abstract
objectivesTo evaluate the impact of an emergency department mechanical ventilation protocol on clinical outcomes and adherence to lung-protective ventilation in patients with acute respiratory distress syndrome.
designQuasi-experimental, before-after trial.
settingEmergency department and ICUs of an academic center. PATIENTS: Mechanically ventilated emergency department patients experiencing acute respiratory distress syndrome while in the emergency department or after admission to the ICU.
interventionsAn emergency department ventilator protocol which targeted variables in need of quality improvement, as identified by prior work: 1) lung-protective tidal volume, 2) appropriate setting of positive end-expiratory pressure, 3) oxygen weaning, and 4) head-of-bed elevation. MEASUREMENTS AND MAIN
resultsA total of 229 patients (186 preintervention group, 43 intervention group) were studied. In the emergency department, the intervention was associated with significant changes (p < 0.01 for all) in tidal volume, positive end-expiratory pressure, respiratory rate, oxygen administration, and head-of-bed elevation. There was a reduction in emergency department tidal volume from 8.1 mL/kg predicted body weight (7.0-9.1) to 6.4 mL/kg predicted body weight (6.1-6.7) and an increase in lung-protective ventilation from 11.1% to 61.5%, p value of less than 0.01. The intervention was associated with a reduction in mortality from 54.8% to 39.5% (odds ratio, 0.38; 95% CI, 0.17-0.83; p = 0.02) and a 3.9 day increase in ventilator-free days, p value equals to 0.01.
conclusionsThis before-after study of mechanically ventilated patients with acute respiratory distress syndrome demonstrates that implementing a mechanical ventilator protocol in the emergency department is feasible and associated with improved clinical outcomes.
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Registered trials
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