Outcome issues of mechanical ventilator settings in acute respiratory distress syndrome patients from Québec ICUs after the 2000 Acute Respiratory Distress Syndrome Network trial

Abstract

Objective. To undertake a retrospective assessment of a knowledge translation of how a low tidal volume setting has affected the overall outcome of acute lung injury (ALI)/acute respiratory distress syndrome (ARDS) patients in Quebec ICUs. Material and methods. This was a study of case files from five Quebec ICUs, separated into two groups: those from before and after November 2000 (i.e. 6 months after the publication of the first ARDS Network trial). The primary outcome was changes in tidal volume. Secondary outcomes comprised mortality, number of days without organ dysfunction/failure, positive end-expiratory pressure (PEEP) level, respiratory rate and partial pressure of CO2 (PaCO2). Results. Of 105 patients, 55 were studied before and 50 after the landmark trial. Compared to the situation before November 2000: (i) tidal volume (normalized to predicted ideal body weight) fell; (ii) PEEP, respiratory rate and PaCO2 rose; and (iii) in-hospital mortality decreased and days without organ failure increased ...