Observational studyAnnals of emergency medicine2017
Lung-Protective Ventilation Initiated in the Emergency Department (LOV-ED): A Quasi-Experimental, Before-After Trial.
Observational study in Annals of emergency medicine, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 53 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
53 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Practice Patterns and Outcomes Associated With Early Sedation Depth in Mechanically Ventilated Patients: A Systematic Review and Meta-Analysis.Critical care medicine · 2018Pooled it
- Effect of Ventilator Mode on Ventilator-Free Days in Critically Ill Adults: A Randomized Clinical Trial.Chest · 2025Trial
- Pulmonary Mechanics and Mortality in Mechanically Ventilated Patients Without Acute Respiratory Distress Syndrome: A Cohort Study.Shock (Augusta, Ga.) · 2018Trial
- Is acute respiratory distress syndrome a preventable disease?Intensive care medicine · 2026Review
- Management of Mechanical Ventilation in Emergency Medicine: A Scoping Review.Journal of the American College of Emergency Physicians open · 2026Review
- Ventilator-Induced Lung Injury: The Unseen Challenge in Acute Respiratory Distress Syndrome Management.Journal of clinical medicine · 2025Review
- Computationally-directed mechanical ventilation in a porcine model of ARDS.Frontiers in physiology · 2025Article
- Knowledge, attitudes, and practice about protective ventilation among physical therapists.PloS one · 2025Article
- Respiratory Therapist-Driven Mechanical Ventilation Protocol Is Associated With Increased Lung Protective Ventilation.Respiratory care · 2024Article
- Investigating distributions of inhaled aerosols in the lungs of post-COVID-19 clusters through a unified imaging and modeling approach.European journal of pharmaceutical sciences : official journal of the European Federation for Pharmaceutical Sciences · 2024Article
- Physical and respiratory therapy in the critically ill patient with obesity: a narrative review.Frontiers in medicine · 2024Review
- Article
- Blueprint for the development of resuscitation and emergency critical care fellowships.AEM education and training · 2023Article
- Disparities Exist in the Application of Low Tidal-volume Ventilation in the Emergency Department.The western journal of emergency medicine · 2023Observational
- Challenges in ARDS Definition, Management, and Identification of Effective Personalized Therapies.Journal of clinical medicine · 2023Review
- What is the Impact of Low Tidal Volume Ventilation for Emergency Department Patients?Annals of emergency medicine · 2023Article
- ["B problems" in non-traumatic resuscitation room management].Notfall & rettungsmedizin · 2023Review
- A computed tomography imaging-based subject-specific whole-lung deposition model.European journal of pharmaceutical sciences : official journal of the European Federation for Pharmaceutical Sciences · 2022Article
- Acute Respiratory Distress Syndrome.Emergency medicine clinics of North America · 2022Review
- Low tidal volume ventilation is associated with mortality in COVID-19 patients-Insights from the PRoVENT-COVID study.Journal of critical care · 2022Observational
Corrections and comments
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Authors and funding
13 authors.
Funding
Abstract
STUDY
objectiveWe evaluated the efficacy of an emergency department (ED)-based lung-protective mechanical ventilation protocol for the prevention of pulmonary complications.
methodsThis was a quasi-experimental, before-after study that consisted of a preintervention period, a run-in period of approximately 6 months, and a prospective intervention period. The intervention was a multifaceted ED-based mechanical ventilator protocol targeting lung-protective tidal volume, appropriate setting of positive end-expiratory pressure, rapid oxygen weaning, and head-of-bed elevation. A propensity score-matched analysis was used to evaluate the primary outcome, which was the composite incidence of acute respiratory distress syndrome and ventilator-associated conditions.
resultsA total of 1,192 patients in the preintervention group and 513 patients in the intervention group were included. Lung-protective ventilation increased by 48.4% in the intervention group. In the propensity score-matched analysis (n=490 in each group), the primary outcome occurred in 71 patients (14.5%) in the preintervention group compared with 36 patients (7.4%) in the intervention group (adjusted odds ratio 0.47; 95% confidence interval [CI] 0.31 to 0.71). There was an increase in ventilator-free days (mean difference 3.7; 95% CI 2.3 to 5.1), ICU-free days (mean difference 2.4; 95% CI 1.0 to 3.7), and hospital-free days (mean difference 2.4; 95% CI 1.2 to 3.6) associated with the intervention. The mortality rate was 34.1% in the preintervention group and 19.6% in the intervention group (adjusted odds ratio 0.47; 95% CI 0.35 to 0.63).
conclusionImplementing a mechanical ventilator protocol in the ED is feasible and is associated with significant improvements in the delivery of safe mechanical ventilation and clinical outcome.
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