Reduction of Mechanical Ventilation Hours Using a Working Protocol with the Cardiopulmonary Management System.

Mikel W. O'Klock RRT, Dennis Harker BS RRT, Aksay Mahadevia MD, FCCP

Genesis Medical Center, Davenport, IA.

Background: Genesis Medical Center (GMC) Davenport Iowa, is a 5500 bed hospital with three adult Intensive Care units (ICUs)(totaling 45 ICU beds.) between two campuses. Mechanical Ventilation Hours (MVH) for fiscal year 2003 totaled 84,000 with an average of 123 hours per patient. Weith this apparently high level, it was decided to adopted a Mechanical Ventilation Management Strategy Protocol incorporating the Respironics Cardiopulmonary Management System (NICO) in an attempt to see if we could effectively reduce MVH.

Methods: We retrospectively measured our MVH for 2003-2004. Next a protocol was implemented using data from the NICO monitor (SBCO₂, VCO₂, ETCO₂, CO and Vd/Vt) and a decision template. After 12 months of managing patients using the protocol, MVH were again measured.

Results: By incorporating the ventilation management protocol, the decision process was simplified for both physician and therapist. This resulted in a significant reduction (p=0.001) in mechanical ventilation hours per patient.

Ventilator Hours Statistical Analysis

Conclusion: BBy implementing a care protocol incorporating the Respironics NICO we observed a decrease of 43.2% in the total number of ventilator hours, and a 42% decrease in the number of hours per patient.