Back to Journals » International Journal of General Medicine » Volume 9

Lung protective mechanical ventilation strategies in cardiothoracic critical care: a retrospective study

Authors Zochios V, Hague M, Giraud K, Jones N

Received 12 September 2016

Accepted for publication 20 October 2016

Published 11 November 2016 Volume 2016:9 Pages 415—418

DOI https://doi.org/10.2147/IJGM.S122204

Checked for plagiarism Yes

Review by Single-blind

Peer reviewers approved by Dr Amy Norman

Peer reviewer comments 2

Editor who approved publication: Dr Scott Fraser


Vasileios Zochios,1–3 Matthew Hague,3,4 Kimberly Giraud,5 Nicola Jones3

1Department of Intensive Care Medicine, Queen Elizabeth Hospital Birmingham, University Hospitals Birmingham NHS Foundation Trust, 2Institute of Inflammation and Ageing, College of Medical and Dental Sciences, University of Birmingham, 3Department of Anesthesia and Intensive Care Medicine, Papworth Hospital NHS Foundation Trust, Papworth Everard, Cambridge, 4Department of Medicine, Colchester Hospital University NHS Foundation Trust, Colchester General Hospital, Colchester, 5Research and Development Department, Papworth Hospital NHS Foundation Trust, Papworth Everard, Cambridge, UK

Abstract: A body of evidence supports the use of low tidal volumes in ventilated patients without lung pathology to slow progress to acute respiratory distress syndrome (ARDS) due to ventilator associated lung injury. We undertook a retrospective chart review and tested the hypothesis that tidal volume is a predictor of mortality in cardiothoracic (medical and surgical) critical care patients receiving invasive mechanical ventilation. Independent predictors of mortality in our study included: type of surgery, albumin, H+, bilirubin, and fluid balance. In particular, it is important to note that cardiac, thoracic, and transplant surgical patients were associated with lower mortality. However, our study did not sample equally from The Berlin Definition of ARDS severity categories (mild, moderate, and severe hypoxemia). Although our study was not adequately powered to detect a difference in mortality between these groups, it will inform the development of a large prospective cohort study exploring the role of low tidal volume ventilation in cardiothoracic critically ill patients.

Keywords: lung protective ventilation, cardiothoracic critical care, acute respiratory distress syndrome, invasive mechanical ventilation

Creative Commons License This work is published and licensed by Dove Medical Press Limited. The full terms of this license are available at https://www.dovepress.com/terms.php and incorporate the Creative Commons Attribution - Non Commercial (unported, v3.0) License. By accessing the work you hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed. For permission for commercial use of this work, please see paragraphs 4.2 and 5 of our Terms.

Download Article [PDF]  View Full Text [HTML][Machine readable]