Lung Protective Ventilation Initiated in the ED (LOV-ED Trial)

• Approximately 250,000 patients per year receive mechanical ventilation that is initiated in the emergency department; 20% of these patients develop a pulmonary complication such as ARDS
• Evidence has shown that ventilator-associated lung injury can occur shortly after initiation of mechanical ventilation. Because many of these patients are intubated and initially managed in the emergency department, there is an important role for us as providers to initiate lung-protective ventilation.
• Initiating lung-protective ventilation in the ED has been shown to decrease ARDS and ventilator associated complications by almost 50%. It has also been shown to increase ventilator-free, ICU-free and hospital-free days, which are all positively correlated with improved morbidity and mortality. 
• See the protocol this team used and the attached ARDSNet preferred body weight (PBW) table

References:

• Fuller BM, Ferguson IT, Mohr NM, et al. Lung-Protective Ventilation Initiated in the Emergency Department (LOV-ED): A Quasi-Experimental, Before-After Trial. Ann Emerg Med. 2017
• PBW Table: http://www.ardsnet.org/files/pbwtables_2005-02-02.pdf
• ARDSNet Protocol Card: http://www.ardsnet.org/files/ventilator_protocol_2008-07.pdf