ICU Implementation Determinants and Delivery of Lung Protective Ventilation

CHEST Critical Care 2026 Open access

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Authors: Chad H. Hochberg, Sophia Emetu, Kevin J. Psoter, Sarina K. Sahetya, Meeta P. Kerlin, Theodore J. Iwashyna, David N. Hager, Michelle N. Eakin
DOI: 10.1016/j.chstcc.2026.100240
Cited by: 2
References: 43

Abstract

BACKGROUND: Lung protective ventilation (LPV) improves mortality in patients with ARDS and is applied widely in other patients receiving mechanical ventilation. Despite strong evidence, LPV is implemented inconsistently. RESEARCH QUESTION: Are staff-rated ICU implementation determinants associated with delivery of patient-level LPV delivery. STUDY DESIGN AND METHODS: > 8 mL/kg PBW on day 1 of mechanical ventilation. We used mixed-effects negative binomial models including LPV hours as the outcome, eligible time as an offset, patient and ICU covariates, and a random effect for ICU. RESULTS: > 8 mL/kg PBW. INTERPRETATION: >8 mL/kg PBW, but not with a stricter LPV definition. These findings may inform development of interventions to enhance ICU implementation determinants and improve LPV delivery.

Fields of Study & Subjects

Respiratory Support and Mechanisms Sepsis Diagnosis and Treatment Nosocomial Infections in ICU

Publication details

Journal / source
CHEST Critical Care
Publisher
Elsevier BV
Volume
4
Issue
1
Pages
100240–100240
Publication date
24 January 2026
Language
EN