Mechanical Ventilation in the Emergency Department: A Prospective Cross-Sectional Study

Despite its life-saving potential, the mechanical ventilator has great potential to do harm. Despite years of research, the mortality in acute lung injury (ALI) remains very high. Treatment options after ALI onset are very limited, therefore prevention may be the best option. Unfortunately, the emergency department has not been studied with respect to mechanical ventilation practices, and its contribution to ALI is unknown. The investigators hypothesize that mechanical ventilation is frequently used in the ED and for a variety of reasons, and that ED mechanical ventilation has an effect on long term outcomes.

Study Overview

• Status: Completed
• Conditions: Respiratory Failure; Acute Lung Injury; Mechanical Ventilation
• Intervention / Treatment: Other: For inclusion in the study, patients will have to require mechanical ventilation either via an endotracheal tube or tracheostomy tube.

• Study Type: Observational
• Enrollment (Actual): 219

Contacts and Locations

Study Locations

• United States
  • Delaware
    • Newark, Delaware, United States, 19718
      • Christiana Care Health System
  • Iowa
    • Iowa City, Iowa, United States, 52242
      • University of Iowa College of Medicine
  • Missouri
    • Saint Louis, Missouri, United States
      • Washington University School of Medicine
  • Ohio
    • Cincinnati, Ohio, United States
      • University of Cincinnati College of Medicine

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Child; Adult; Older Adult
• Accepts Healthy Volunteers: No
• Genders Eligible for Study: All

• Sampling Method: Non-Probability Sample

Study Population

Patients presenting to the emergency department requiring invasive mechanical ventilation.

Description

Inclusion Criteria:

• Ventilation either via an endotracheal tube or tracheostomy

Exclusion Criteria:

• Non-invasive positive pressure ventilation;
• Death in the immediate post-intubation phase of care;
• Chronic ventilator-dependence, either at home or extended care facility.

Study Plan

How is the study designed?

Number of groups / cohorts

1

Cohorts and Interventions

Group / Cohort	Intervention / Treatment
All ED patients requiring mechanical ventilation	Other: For inclusion in the study, patients will have to require mechanical ventilation either via an endotracheal tube or tracheostomy tube.; Mechanical ventilation via an endotracheal tube or tracheostomy tube

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
To Further Characterize ED Mechanical Ventilation	In a prospective cross-sectional study design, we will enroll all patients receiving mechanical ventilation in the ED over a one-month time frame.	1 month

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
The Incidence of ARDS in Mechanically Ventilated Emergency Department Patients, and Risk Factors Associated With Progression to ARDS	Development of ARDS after admission to the hospital	1 month

Collaborators and Investigators

• Sponsor: Washington University School of Medicine
• Collaborators: University of Iowa; Christiana Care Health Services; University of Cincinnati
• Investigators: Principal Investigator: Brian M Fuller, MD, Washington University School of Medicine in St. Louis

Publications and helpful links

General Publications

• Fuller BM, Mohr NM, Miller CN, Deitchman AR, Levine BJ, Castagno N, Hassebroek EC, Dhedhi A, Scott-Wittenborn N, Grace E, Lehew C, Kollef MH. Mechanical Ventilation and ARDS in the ED: A Multicenter, Observational, Prospective, Cross-sectional Study. Chest. 2015 Aug;148(2):365-374. doi: 10.1378/chest.14-2476.

Study record dates

Study Major Dates

• Study Start: July 1, 2012
• Primary Completion (Actual): August 1, 2013
• Study Completion (Actual): March 1, 2014

Study Registration Dates

• First Submitted: June 20, 2012
• First Submitted That Met QC Criteria: June 25, 2012
• First Posted (Estimate): June 26, 2012

Study Record Updates

• Last Update Posted (Actual): March 23, 2020
• Last Update Submitted That Met QC Criteria: March 9, 2020
• Last Verified: March 1, 2020

More Information

Terms related to this study

• Keywords: Respiratory failure; Mechanical ventilation; Acute lung injury
• Additional Relevant MeSH Terms: Pathologic Processes; Respiratory Tract Diseases; Respiration Disorders; Lung Diseases; Wounds and Injuries; Disease Attributes; Thoracic Injuries; Emergencies; Respiratory Insufficiency; Acute Lung Injury; Lung Injury
• Other Study ID Numbers: 201205165