Impact of a Respiratory Therapist-Initiated Lung Protective Ventilation Strategy

Background: Low tidal volume targeted ventilation (LTVV) has been recommended as a standard strategy for adult mechanically ventilated patients and is associated with reduced mortality. Adoption of LTVV has been reported to range between 19% – 75%. All cause hospital mortality for adult mechanically ventilated patients has been reported at 28%. We sought to evaluate how a respiratory therapist directed LTVV model applied at the onset of mechanical ventilation would compare to previously reported LTVV practices. We also compared all cause hospital mortality. Methods: This IRB approved retrospective analysis included electronic medical record review of adult mechanically ventilated (MV) patients managed between March 2018 and March 2019. 1,425 subjects required MV for > 24 hours. The primary outcome was the percentage of subjects receiving set VT