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Assessing Provider Adherence To A Lung Protective Ventilation Protocol In Patients Undergoing Thoracic Surgery Using One-Lung Ventilation

Rawley, Michael; Harris, Erica; Pospishil, Liliya; Thompson, Julie A; Falyar, Christian
Patients undergoing one-lung ventilation (OLV) are at risk for lung injury leading to postoperative pulmonary complications (PPCs). Lung protective ventilation (LPV) challenges traditional anesthetic management by using lower tidal volumes, individualized positive end-expiratory pressure (PEEP), and recruitment maneuvers (RMs). LPV reduces driving pressure when properly applied, which reduces the incidence of PPCs. An LPV protocol was developed and implemented for this study for patients undergoing one-lung ventilation. Knowledge and confidence were measured prior to, immediately following, and 12 weeks after an educational offering and distribution of cognitive aids. Clinical data were collected 12 weeks prior to implementation, immediately after implementation, and again at 12 weeks post-implementation. There was a significant increase in provider knowledge regarding LPV (P = .015). A significant adherence to monitoring driving pressures (P < .05) was observed at 12 weeks post-implementation. There were increases in adherence to each component (tidal volume, PEEP, RM, and FiO2) as well as overall adherence (P = .356). Implementation of the protocol resulted in increased adherence to lung protective strategies, including a statistically significant decrease (P < 0.05) in driving pressure which has been shown to reduce complications in patients having thoracic surgery with OLV.
PMID: 36413189
ISSN: 2162-5239
CID: 5374492

Antifibrinolytic dosing in cardiac surgery: Is non-weight based dosing advisable with cardiopulmonary bypass?

Neuburger, Peter J; Pospishil, Liliya
PMID: 35870167
ISSN: 1540-8191
CID: 5279442

Transcatheter tricuspid valve repair with the PASCAL repair system: A review of emerging technology [Editorial]

Wu, Isaac Y; Gu, Yang; Pospishil, Liliya; Neuburger, Peter J
PMID: 35871046
ISSN: 1532-8422
CID: 5279472

The AVATAR Trial for Severe Asymptomatic Aortic Stenosis: Wait or Operate? [Editorial]

Neuburger, Peter J; Patel, Kinjal M; Pospishil, Liliya
PMID: 35779994
ISSN: 1532-8422
CID: 5281562

Vascular Access CLOSURE in Transcatheter Aortic Valve Implantation: Is There A Better CHOICE? [Editorial]

Pospishil, Liliya; Krishnan, Sandeep; Neuburger, Peter J
PMID: 35473815
ISSN: 1532-8422
CID: 5217422

Contemporary Practice of Echocardiography in Transcatheter Aortic Valve Replacement [Editorial]

Pospishil, Liliya; Nampi, Robert G; Neuburger, Peter J
PMID: 34366216
ISSN: 1532-8422
CID: 5006092

Anesthetic Management of Conduction Disturbances Following Transcatheter Aortic Valve Replacement: A Review of the 2020 ACC Expert Consensus Decision Pathway [Editorial]

Neuburger, Peter J; Pospishil, Liliya; Ibrahim, Homam
PMID: 33441272
ISSN: 1532-8422
CID: 4746992

TAVR Versus SAVR for the Treatment of Aortic Stenosis: Do We Have a Clear Winner? [Editorial]

Nampi, Robert G; Pospishil, Liliya; Neuburger, Peter J
PMID: 32418828
ISSN: 1532-8422
CID: 4443692

In Pursuit of a Unicorn: Does the Ideal Parameter for Grading of Aortic Stenosis During Intraoperative Transesophageal Echocardiography Exist? [Editorial]

Pospishil, Liliya; Patel, Prakash A; Neuburger, Peter J
PMID: 31138469
ISSN: 1532-8422
CID: 3921462

Surgically Assisted Transcatheter Balloon-Expandable Valve in Inferior Vena Cava for Torrential Tricuspid Regurgitation

Mulaikal, Teresa A; Pospishil, Liliya; George, Isaac; Bapat, Vinayak N; Hahn, Rebecca T
PMID: 30370378
ISSN: 2468-6441
CID: 3399342