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13.11.2017 | Short Communication | Ausgabe 1/2018

Journal of Anesthesia 1/2018

Quick reference tidal volume cards reduce the incidence of large tidal volumes during surgery

Zeitschrift:
Journal of Anesthesia > Ausgabe 1/2018
Autoren:
Chirag K. Shah, Angela Moss, William Henderson, Breandan Sullivan, Ana Fernandez-Bustamante
Wichtige Hinweise
In 2014, this work was partially presented to the Society of Cardiovascular Anesthesiologists (BS) and the American Society of Anesthesiologists (AFB).

Abstract

Ventilation with large tidal volumes (V T), greater than 10 ml/kg of predicted body weight (PBW), is associated with worse outcomes in critically ill and surgical patients. We hypothesized that the availability of quick reference cards with proposed V T ranges specific to gender and different heights would reduce the intraoperative use of large V T during prolonged abdominal surgery. We compared retrospectively the incidence of median V T used during prolonged (≥4-h-long) abdominal surgery before (“before”) and after (“after”) the quick reference V T cards were made available in all anesthesia machines in operating rooms of a single academic US medical center. We evaluated the effect of the intervention on the primary outcome while adjusting for previously identified risk factors of large V T use: female gender, obesity (body mass index, BMI > 30), and short height (< 165 cm). The frequency of V T > 10 ml/kg PBW was 15.1% in the before group and 4.3% in the after group (p < 0.001). The frequency of large V T used during abdominal surgery was significantly decreased after the intervention even after adjusting for female gender, obesity or short height [adjOR 0.11 (95% CI 0.04–0.30)]. Our quick reference V T cards significantly reduced the frequency of large V T use during abdominal surgery.

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