Adhere-LPV在肺部保护通风中推进高质量的基于证据的呼吸努力

Patients in one of the 10 participating hospitals who require mechanical ventilation randomized to the current ventilator order that is used across the health system.

Current ventilator order used by control hospitals

Patients in one of the 10 participating hospitals who require mechanical ventilation randomized to a new ventilation order

The new ventilator order (intervention) was developed using economic behavior theory to decrease the cognitive burden on the ordering provider while enhancing the operability of the order itself. The strategy resulted in a new ventilator order that includes the following changes:

1. Automatic calculation of the PBW based on the most recent height
2. If the height is not available, an order to obtain a height will be generated and the choice of tidal volume will be based on cc/kg PBW
3. Simplify ventilator modes to accurately reflect the standard of care
4. Reduce duplicative information in the monitoring and comments portion of the order
5. Cascade ventilator orders based on mode to enhance visualization.

The primary outcome is a binary indicator of lung-protective ventilation (set tidal volume of 8 mL/kg predicted body weight or less) at the first documented set tidal volume at least 4 hours after the start of invasive mechanical ventilation.