Podcast 782: Ventilator Management

Emergency Medical Minute

Contributor: Aaron Lessen, MD

Educational Pearls:

• Tidal volume is the amount of breath a patient receives in a single ventilation
• Traditional tidal volume (TV) setting was 10 ml/kg but studies showed lower TV had less incidence of respiratory distress, ARDS, and overall better outcomes
• ED ventilation settings may get carried on for hours or days when a patient is admitted, making this an important part of patient care
• Recent large systematic review shows that low TV setting in the ED leads to decreased incidence of ARDS, shorter ICU and hospital length of stay, shorter duration of mechanical ventilation, and decreased mortality
• Consider an ED low tidal volume ventilation setting at around 6 ml/kg of predicted body weight

References

De Monnin K, Terian E, Yaegar LH, et al. Low Tidal Volume Ventilation for Emergency Department Patients: A Systematic Review and Meta-Analysis on Practice Patterns and Clinical Impact [published online ahead of print, 2022 Feb 7]. Crit Care Med. 2022;10.1097/CCM.0000000000005459. doi:10.1097/CCM.0000000000005459

Summarized by Kirsten Hughes, MS4 | Edited by John Spartz MS4 & Erik Verzemnieks, MD

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