In most cases, ventilators save lives—but like any other medical procedure, it doesn’t come without risks. Ventilator-associated lung injuries (VALI) occur when improper ventilation techniques are used, and can result in pulmonary edema, barotrauma, or worsening hypoxemia that can prolong mechanical ventilation.
In the worst cases, VALI can also lead to multi-system organ dysfunction and increase the chances of mortality in the patient.
Best Practices to Minimize the Risk of Ventilator-Associated Lung Injuries
To minimize the risks of complications, it’s essential to follow strict protocols and best practices while placing and managing ventilated patients.
Below, we lay out key strategies to prevent VALI and highlight the role of advanced training tools in ensuring safe and effective ventilation.
What Are Ventilator-Associated Lung Injuries?
Ventilator associated lung injury occurs when mechanical ventilation, though life-saving in most cases, inadvertently causes harm to the lung tissue. This damage can lead to complications with serious consequences. Common types of VALI include:
- Pulmonary edema: When fluid collects in the many air sacs in the lungs making it difficult to breathe. Pulmonary edema may lead to death.
- Pulmonary barotrauma: When the air pressure in the lungs changes too quickly, causing damage to the lung tissue. Pulmonary barotrauma can lead to a collapsed lung or death.
- Worsening hypoxemia: When oxygen levels in the blood are lower than normal, which can interfere with heart and brain function. It can also lead to a lack of oxygen in your body’s organs and tissues.
- Multi-system organ dysfunction: When two or more organ systems are failing. It’s a serious medical emergency that’s fatal without immediate treatment.
Each of these injuries can make the patient’s condition much worse, leading to a prolonged hospital stay, requiring further life-saving measures, and even increasing the risk of mortality. It’s clear that proper management of ventilator settings, comprehensive monitoring, and an awareness of patient-specific factors is crucial.
What are the Best Practices in Ventilator Management?
Most hospitals and/or medical providers have best practices in place for every procedure and process performed. Ventilator management is one of the most important processes in life-saving situations, so adopting best practices related to ventilation is crucial.
Luckily, there are a number of well-established best practices in mechanical ventilation management that can help keep patients safe during ventilation:
- Low Tidal Volume Ventilation (LTVV): Using lower tidal volumes (typically 4-8 mL/kg of ideal body weight) is crucial to reducing the risk of lung overdistention and other complications.
- Optimal Positive End-Expiratory Pressure (PEEP): At the end of mechanical or spontaneous exhalation, PEEP maintains the patient’s airway pressure above the atmospheric level by exerting pressure that opposes passive emptying of the lung. Ensuring safe yet effective PEEP levels can also decrease the risk of VALI.
- Limiting Plateau Pressure: Maintaining plateau pressures below 30 cm H₂O helps prevent barotrauma, which is caused by excessive pressure on the lungs. Regular monitoring ensures ventilation settings are optimal for the patient’s condition.
- Individualized Ventilation Strategies: Tailoring ventilation settings to the specific lung mechanics and disease state of each patient helps ensure both effective and safe ventilatory support.
- Early Mobilization and Sedation Management: Reducing sedation as early as safely possible and promoting early mobilization can help shorten the duration of mechanical ventilation, reducing the risk of associated complications.
Strategies to Prevent Ventilator-Associated Lung Injuries
In addition to the above established protocols and best-practices, healthcare providers can adopt other strategies to enhance the safety and efficacy of mechanical ventilation, such as:
- Continuous Monitoring: Utilize advanced monitoring tools to assess lung mechanics, gas exchange, and patient-ventilator interaction in real-time to make the best decisions for each individual patient.
- Interdisciplinary Collaboration: Ensure that respiratory therapists, nurses, and physicians work closely together to optimize ventilatory support and adjust settings as needed.
- Regular Training and Simulation: Ongoing education and hands-on training in ventilator management are essential to keep healthcare professionals up-to-date with the latest techniques and technologies.
How to Enhance Confidence and Precision in Providers and Reduce Ventilator-Associated Lung Injuries
While all of the previously mentioned strategies are critical in reducing ventilator associated lung injury, it’s crucial for medical organizations to recognize and remember that proper, ongoing training is a great way to prevent ventilator-associated lung injuries.
Why Training Matters
Hands-on experience with lung simulators and ventilation products enables doctors and respiratory therapists to gain a deeper understanding of lung mechanics and the complexities of ventilator management.
Personnel, technologies, and techniques are regularly changing and evolving. Lung Simulators allow caregivers to get comfortable with new techniques and devices in a risk-free environment prior to applying them to actual patients.
How to Build Confidence
Regular training with the addition of lung simulators helps healthcare professionals become more confident in placing ventilators and adjusting settings to suit individual patient needs. This confidence translates to better patient outcomes, as clinicians are more adept at avoiding common pitfalls associated with mechanical ventilation.
How to Practice Precision in Care
Accurate placement and management of ventilators are critical in preventing VALI. By using training models and products, healthcare professionals are provided the opportunity to practice the precision needed to ensure that ventilatory support is both safe and effective, reducing the likelihood of lung injuries and improving overall patient care.
Prevent Ventilator-Associated Lung Injury with Michigan Instruments
Preventing ventilator-associated lung injuries requires a combination of following established protocols, engaging in ongoing education, and the use of advanced training tools.
By investing in comprehensive training with Michigan Instruments’ products, such as the Training Test Lung, healthcare professionals can enhance their skills, boost their confidence, and deliver the highest standard of care to their patients.
