UMEM Educational Pearls

ED Low-Tidal Volume Ventilation

  • Low-tidal volume ventilation (LTVV) reduces mortality in patients with ARDS and may reduce mortality in patients without ARDS.
  • Recent literature has highlighted the importance of initial ED ventilator settings, as these often persist for many hours after ICU admission.
  • But..does the use of LTVV in the ED really make a difference?
  • A recent systematic review and meta-analysis sought to evaluate the use of LTVV in the ED and the impact upon clinical outcomes.
  • In short, the use of LTVV in the ED was associated with an increase in the use of LTVV in the ICU, decreased occurrence of ARDS after admission, shorter ICU and hospital lengths of stay, decreased duration of mechanical ventilation, and decreased mortality.
  • Take Home Point:  The use of LTVV in the ED makes a difference!

References

Monnin KE, et al. Low tidal volume ventilation for emergency department patients: A systematic review and meta-analysis on practice patterns and clinical impact. Crit Care Med. 2022; published online Feb 7, 2022.