A literature review found evidence-based practices (EBPs) to be associated with fewer ventilator days and/or lower mortality rates among patients who received invasive mechanical ventilation for acute respiratory failure or ARDS, according to a study published in Chest.1
According to researchers, it’s the “first comprehensive review of EBPs to address care across the full continuum, from intubation to liberation, for patients who received IMV for ARF and/or ARDS.”1
Of a total of 20 EBPs that indicated shorter duration of IMV and/or a mortality rate benefit, six of them focus on intubation and escalation of care. Ten EBPs reduce complications. We also identified four EBPs that address deescalation of interventions and the promotion of extubation.1
Clinically, we brought all of these recommendations, which were previously in separate guidelines, systematic reviews, and meta-analyses, into a single set and identified where they fit on the continuum from intubation to liberation. This focuses attention on the need to address the entire continuum, not isolated components.1
Summary of the Systematic Reviews, Meta-Analyses, and Guidelines That Were Included1
| Review | Care Continuum Phase | Evidence-Based Practice | Evidence-Based Practice Description | Impact on Outcome (MV) | Impact on Outcome (Death) | Recommended for Use | Level of Evidence |
| Aggarwal et al (2018) | 1 | Conservative oxygen therapy | The goal of PO2 in arterial blood is 55-80 mm Hg; oxygen exposure 80 mm Hg is associated with worse patient outcomes, irrespective of the severity of ARDS. | Yes | Yes | Yes | Moderate |
Read the full study at journal.chestnet.org
- Ervin J, et al. “Evidence-based practices for acute respiratory failure and acute respiratory distress syndrome: A systematic review of reviews,” Chest. DOI: 10.1016/j.chest.2020.06.080
