ArticleJournal of critical care2021
Implementation of lung protective ventilation order to improve adherence to low tidal volume ventilation: A RE-AIM evaluation.
Article in Journal of critical care, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 12 papers.
What it found
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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.
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Who cites it
12 citing papers in PubMed, 16 citations in OpenAlex.
- Bench evidence, bedside uncertainty: hyperoxia, mechanical ventilation and lung injury.European respiratory review : an official journal of the European Respiratory Society · 2026Review
- Prone Positioning in a North American Cohort of Hypoxemic Patients on Mechanical Ventilation.Critical care medicine · 2026Observational
- Prone Positioning in a North American Cohort of Hypoxemic Patients on Mechanical Ventilation.medRxiv : the preprint server for health sciences · 2025Article
- Role of Attending Practice Variability in Prone Positioning Initiation: A Retrospective Cohort Study.CHEST critical care · 2025Article
- A systematic review of clinicians' acceptance and use of clinical decision support systems over time.NPJ digital medicine · 2025Article
- Knowledge, attitudes, and practice about protective ventilation among physical therapists.PloS one · 2025Article
- A scoping review, novel taxonomy and catalogue of implementation frameworks for clinical decision support systems.BMC medical informatics and decision making · 2024Article
- Lung Protective Ventilation Adherence and Outcomes for Patients With COVID-19 Acute Respiratory Distress Syndrome Treated in an Intermediate Care Unit Repurposed to ICU Level of Care.Critical care explorations · 2024Observational
- Quality improvement project to improve adherence to lung protective ventilation guidelines.BMJ open quality · 2024Article
- Initiation of a Lung Protective Ventilation Strategy in the Emergency Department: Does an Emergency Department-Based ICU Make a Difference?Critical care explorations · 2022Article
- Quality Improvement Intervention associated with Improved Lung Protective Ventilation Settings in an Emergency Department.Spartan medical research journal · 2022Article
- Lung-Protective Ventilation Over 6 Years at a Large Academic Medical Center: An Evaluation of Trends, Adherence, and Perceptions of Benefit.Critical care explorations · 2021Article
Corrections and comments
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Authors and funding
8 authors at 4 institutions in 1 country.
Funding
Abstract
purposeLung protective ventilation (LPV), defined as a tidal volume (Vt) ≤8 cc/kg of predicted body weight, reduces ventilator-induced lung injury but is applied inconsistently. MATERIALS AND
methodsWe conducted a prospective, quasi-experimental, cohort study of adults mechanically ventilated admitted to intensive care units (ICU) in the year before, year after, and second year after implementation of an electronic medical record based LPV order, and a cross-sectional qualitative study of ICU providers regarding their perceptions of the order. We applied the Reach, Efficacy, Adoption, Implementation, and Maintenance (RE-AIM) framework to evaluate the implementation.
resultsThere were 1405, 1424, and 1342 in the control, adoption, and maintenance cohorts, representing 95% of mechanically ventilated adult ICU patients. The overall prevalence of LPV increased from 65% to 73% (p < 0.001, adjusted-OR for LPV adherence: 1.9, 95% CI 1.5-2.3), but LPV adherence in women was approximately 30% worse than in men (women: 44% to 56% [p < 0.001],men: 79% to 86% [p < 0.001]). ICU providers noted difficulty obtaining an accurate height measurement and mistrust of the Vt calculation as barriers to implementation. LPV adherence increased further in the second year post implementation.
conclusionWe designed and implemented an LPV order that sustainably improved LPV adherence across diverse ICUs.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.