OUTCOME OF ACUTE RESPIRATORY DISTRESS SYNDROME NETWORK PROTOCOL IMPLEMENTATION IN PATIENTS WITH ACUTE LUNG INJURY/ACUTE RESPIRATORY DISTRESS SYNDROME.

Abstract

There is under-use of ARDS Network ventilatory protocol in managing ARDS patients. Hence the objective of this study was to assess the impact of implementing ARDS network protocol, as a ventilatory strategy in management of ALI/ARDS patients.
Design: retrospective-prospective comparative study.
Patients and Methods: This study was conducted on 40 mechanically ventilated patients with ARDS admitted at ICUs of Zagazig University Hospitals. Twenty newly admitted cases of ALI/ARDS (group I)(prospective group) that have been managed by ARDS Network protocol of mechanical ventilation were compared with another 20 patients who have not been managed by ARDS Network protocol of mechanical ventilation (group II) (retrospective group).
Results: Both groups were matched as regards age, sex,smoking habits, oxygenation ratio and SAPS II on admission .There were a significant statistical difference between both groups as regards tidal volume and plateau pressure on days 1,3 &7 with mortality ( 60% vs. 90% p= 0.028) , duration of MV(18.6 vs. 25.5 days p = 0.001), LOS in ICU among survivors (22.6 vs. 30.5 days p=0.001)and barotraumas ( 1 vs. 6 patients p= 0.037) in group I and group II respectively.
Conclusions: Application of ARDS Network ventilatory protocol as a ventilatory strategy in ARDS patients decreases the overall mortality, days on mechanical ventilation, the length of stay in ICU and the incidence of barotrauma.
Key words: ARDS, mechanical ventilation, low tidal volume, ARDS Network, ICU.