1 / 24

Cecilia Loudet Gabriela Vidal Vinicius Torsani Julio Fiore Jr. Fernando Queiroga Arturo Huerta

MECOR COURSE LEVEL 1. “Use of lung-protective ventilation strategy in acute respiratory distress syndrome (ARDS) in teaching and non-teaching hospitals: a pilot study”. Cecilia Loudet Gabriela Vidal Vinicius Torsani Julio Fiore Jr. Fernando Queiroga Arturo Huerta

munin
Télécharger la présentation

Cecilia Loudet Gabriela Vidal Vinicius Torsani Julio Fiore Jr. Fernando Queiroga Arturo Huerta

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript

  1. MECOR COURSE LEVEL 1 “Use of lung-protective ventilation strategy in acute respiratory distress syndrome (ARDS) in teaching and non-teaching hospitals: a pilot study” Cecilia Loudet Gabriela Vidal Vinicius Torsani Julio Fiore Jr. Fernando Queiroga Arturo Huerta Coordinators: Elisa Estenssoro Peter Wagner

  2. Introduction • Research question • Is lung-protective ventilation strategy in ARDS patients more commonly used in teaching hospitals than in non-teaching hospitals? • Hypothesis • Lung-protective ventilation strategy in patients with ARDS is more frequently used in teaching than in non-teaching hospitals.

  3. Significance & Background • Many studies suggest that evidence-based practice is not being transmitted to clinical practice. • Lung-protective ventilation strategy in patients with ARDS is strongly recommended in the medical literature, but not frequently applied. • We propose a pilot study since there are no data in Latin America dealing with these topics.

  4. Young M. Crit Care Med. 32(6):1260-1265.

  5. The Acute Respiratory Distress Syndrome Network N Engl J Med 2000; 342:1301-1308.

  6. Study design and time frame • Multinational • Multicenter • Cross sectional study • Six-month duration

  7. Selection criteria • Inclusion criteria Patients in mechanical ventilation who meet the criteria for ARDS (AECC) • Exclusion criteria • Do-not-resuscitate orders • Contraindications for lung-protective ventilation strategy

  8. Variables • Exposure variables • Teaching hospital: with internal medicine or critical care residents working in the ICU. • Non-teaching hospital: without internal medicine or critical care residents working in the ICU.

  9. Variables • Outcome variables - Use of lung-protective ventilatory strategy in patients with ARDS defined as: • Tidal volume less than 6.5 ml/kg OR • Tidal volume less than 6.5 ml/kg and plateau pressure less than 30 mmHg OR • Tidal volume less than 8 ml/kg and plateau pressure less than 30 mmHg

  10. Variables • Outcome variables - Use of lung-protective ventilatory strategy in patients with ARDS defined as: • Tidal volume less than 6.5 ml/kg OR • Tidal volume less than 6.5 ml/kg and plateau pressure less than 30 mmHg OR • Tidal volume less than 8 ml/kg and plateau pressure less than 30 mmHg

  11. Variables • Outcome variables - Use of lung-protective ventilatory strategy in patients with ARDS defined as: • Tidal volume less than 6.5 ml/kg OR • Tidal volume less than 6.5 ml/kg and plateau pressure less than 30 mmHg OR • Tidal volume less than 8 ml/kg and plateau pressure less than 30 mmHg

  12. Variables • Outcome variables - Use of lung-protective ventilatory strategy in patients with ARDS defined as: • Tidal volume less than 6.5 ml/kg OR • Tidal volume less than 6.5 ml/kg and plateau pressure less than 30 mmHg OR • Tidal volume less than 8 ml/kg and plateau pressure less than 30 mmHg

  13. 2 x 2 table OUTCOME: PROTECTIVE VENTILATION + - + ? ? EXPOSURE: TEACHING HOSPITAL ? ? -

  14. Procedures • 18 ICUs will be sampled: (6 per country) • 2 in teaching hospitals • 4 in non-teaching hospitals

  15. Procedures • During 4 consecutive days, at 10 am., investigators will record in a pre-impressed sheet of paper: • Patient demographics • Ventilator settings • Blood gases • Blood chemistry

  16. Statistics • Sample size - Will be calculated after this pilot, which will allow us to have an effect size • Analysis: • Chi2 test • “p” value  0,05 • If data of the pilot study are consistent (small variability) = the definitive study will be a one day cross-sectional study

  17. Budget estimation • Computer: US$ 1.000 x 3 • Paper: US$ 50 • Printer: US$ 150 • Tonner: US$ 50 • Researchers (total): US$ 2160 (US$ 30/day) • Transport: US$ 720 • Total: US$ 6130

  18. Take-home messages: • CONCEPTOS CLAROS!

  19. Take-home messages: • SENTIDO DE ÉXITO!

  20. Take-home messages: • “ESTADISSSTICA”!

  21. Take-home messages: • ¿How rare?...

  22. “p” VALUE RARE!!!!

  23. THANK YOU MECOR!!!

  24. Acknowledgements • Gordon Rubenfeld • Señor Bill • Cindy Rand • Steve McCurdy • Peter Wagner • Elisa Estenssoro • All the faculty of MECOR

More Related