- Poster presentation
- Open Access
Respiratory Mechanics in Acute Respiratory Distress Syndrome: A Quality Improvement Based Registry Project
© Chen et al.; 2015
- Published: 1 October 2015
- Acute Respiratory Distress Syndrome
- Ventilator Setting
- Respiratory Mechanic
- Acute Respiratory Distress Syndrome Patient
- Quality Improvement Program
The amount of pathophysiological impairment in patients with acute respiratory distress syndrome (ARDS) is variable and applying the same ventilator regimen to every patient is questionable. Monitoring of respiratory mechanics for the lung and chest wall allows an individualization of ventilator settings with a potential benefit for the patient. a registry with a large sample size will elicit helpful epidemiological information and may inform future recommendations. We therefore proposed a quality improvement (QI) program constituted by systematic assessment of respiratory mechanics and gas exchange response. the collected data are then introduced into a registry. We report here the preliminary results.
The QI program aims at facilitating the integration of respiratory mechanics monitoring in ventilatory management. the primary objective of the registry is to investigate the epidemiology of abnormalities in respiratory mechanics in ARDS patients.
Two ICUs in Toronto and one ICU in Beijing have initiated this multi-center project. Patients admitted to the ICUs who meet the Berlin definition of ARDS are eligible. Placement of an esophageal catheter is considered when PaO2/FiO2 ≤200. Systematic measurement are performed by the clinicians, including respiratory mechanics, lung and chest wall mechanics, oxygenation response to PEEP, and alveolar derecruitment using a simplified decremental PEEP maneuver. After obtaining the first measurement, a comparison of ventilator settings before and after measurements is conducted and we also report the epidemiology of respiratory mechanics abnormalities observed.
Epidemiology of respiratory mechanics (N = 50).
PaO2/FiO2, low PEEP*
PaO2/FiO2, high PEEP*
A QI program integrating respiratory mechanics monitoring with ventilator management is feasible, lead to individual adaptations and can provide epidemiological information for better understanding respiratory mechanics in ARDS patients.
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