Patient-Ventilator Assessment

Publication Date: January 1, 1970
Last Updated: October 1, 2024

Summary of Recommendations

We recommend the assessment of Pplat to ensure lung protective ventilator settings. (S, H )
620
We recommend an assessment of VT to ensure lung protective ventilation (4–8 mL/kg/predicted body weight). (S, H )
620
We recommend documenting VT as mL/kg predicted body weight. (S, H )
620
We recommend an assessment of PEEP and auto-PEEP. (S, H )
620
We suggest assessing driving pressure to prevent ventilator-induced injury. (C, L )
620
We suggest assessing FIO2 to ensure normoxemia. (C, VL )
620
In noninvasively and invasively mechanically ventilated patients, we suggest the use of telemonitoring to supplement direct bedside assessment in settings of limited resources. (C, L )
620
In noninvasively and invasively mechanically ventilated patients, we suggest that direct bedside assessment rather than telemonitoring be used when resources are adequate. (C, L )
620
We suggest assessing adequate humidification for patients receiving NIV and invasive mechanical ventilation. (C, VL )
620
We suggest assessing the appropriateness of the humidification device during NIV and invasive mechanical ventilation. (C, L )
620
We recommend that the skin surrounding artificial airways and NIV interfaces be assessed. (S, H )
620
We suggest assessing the dressing used for tracheostomy tubes and NIV interfaces. (C, L )
620
We recommend assessing the pressure inside the cuff of artificial airways using a manometer. (S, H )
620
We recommend that continuous cuff pressure assessment should not be implemented to decrease the risk of VAP. (S, H )
620
We suggest assessing proper placement and securement of artificial airways. (C, VL )
620

Recommendation Grading

Disclaimer

The information in this patient summary should not be used as a substitute for professional medical care or advice. Contact a health care provider if you have questions about your health.

Overview

Title

Patient-Ventilator Assessment

Authoring Organization

American Association for Respiratory Care

Last Updated Month/Year

October 7, 2024

Document Type

Guideline

Country of Publication

US

Document Objectives

This CPG provides guidance in 4 areas related to PVA: lung-protective ventilation, use of telemedicine, adequacy of airway humidification, and artificial airway/interface assessment. The recommendations are offered to assist bedside clinicians in the care of patients receiving invasive mechanical ventilation and NIV. The focus of the PVA should be patient-centric rather than focused on the ventilator, which requires a skilled clinician to make the proper assessment, interpret the findings relative to the individual patient, and then adjust the ventilator to meet the patient’s needs.

PICO Questions

  1. Does the assessment of lung-protective ventilation reduce mortality?

  2. Does remote (telehealth) PVA versus bedside assessment result in similar outcomes?

  3. Does assessing patients receiving mechanical ventilation for adequate humidity improve patient outcomes?

  4. Does assessing the artificial airway/interface prevent complications?

Inclusion Criteria

Male, Female, Adolescent, Adult, Child, Infant, Older adult

Health Care Settings

Hospital, Operating and recovery room

Intended Users

Nurse, nurse practitioner, physician, physician assistant

Scope

Assessment and screening, Management, Prevention

Diseases/Conditions (MeSH)

D014691 - Ventilation

Keywords

mechanical ventilation, ventilation

Source Citation

Goodfellow LT, Miller AG, Varekojis SM, LaVita CJ, Glogowski JT, Hess DR. AARC Clinical Practice Guideline: Patient-Ventilator Assessment. Respir Care. 2024 Jul 24;69(8):1042-1054. doi: 10.4187/respcare.12007. PMID: 39048148; PMCID: PMC11298231.