Adoption of low tidal volume ventilation in the emergency department: A quality improvement intervention

Ventilator tidal volumes of >8 mL/kg of predicted body weight (PBW) may increase the risk of lung injury. We sought to evaluate the impact of a quality improvement intervention among intubated Emergency Department (ED) patients to protocolize the prescription of low tidal volume ventilation. In this before-and-after study, the average tidal volume delivered to ED patients receiving volume assist-control ventilation was compared before (2007–2014) and after (2015–2016) implementation of a ventilator initiation protocol (the quality improvement intervention). The intervention emphasized 1) measurement of the patient's height to calculate PBW and therefore tailor the tidal volume to estimated lung size (