Can a Novel In Vivo and Hands on Learning Experience on Lung Protective Ventilation Modify Clinical Practice?

Abstract

Background:

Identification of the optimal mechanical breath profile (MBp) is one of the most significant challenges clinicians encounter when managing patients with ARDS. Our Individualized Mechanical Ventilation (IndiVent) Work Group convened for the third year in a row to discuss current approaches to applying lung protective strategies in ARDS and apply these principles during an in vivo workshop of a surfactant deactivated porcine ARDS model. One of the goals of this project was to evaluate the novelty of this teaching strategy and its potential impact to change current practice.

Methods:

Forty-eight health care professionals (MD 5; PA 1; RT 42) from the US (n=41), China (n=5), and Canada (n=2) discussed concepts related to the optimal MBp over 3 days and participated an in vivo study of four adult surfactant deactivated porcine ARDS models. A 15-item questionnaire was designed to evaluate the perceived value of the overall learning experience and its potential to change current practice. Animal Institutional Review Board approved the study.

Results:

Thirty six percent of the work group had at least a previous opportunity to participate in studies of mechanical ventilation (MV) using an animal model, but less than 50% were familiar with alveolar physiology during MV, the differences between macro and micro ventilation, the myths and misconceptions of APRV, and the preemptive use of APRV. Majority (96%) considered very likely to suggest or modify current lung protective strategies based on the educational and hands on experience. Thirty-nine participants (87%) considered the in vivo lab experience very valuable and their understanding of MV and modes improved. Twenty-six participants (58%) considered that the gross anatomy (excised lung) provided important information regarding the effectiveness of the strategy used during the experiment. Ninety six percent (n=43) of the participants would suggest to colleagues to participate in a similar educational summit and 98% agreed that this experience should be presented as a mini symposium at a conference.

Conclusions:

The results of this survey suggest that the method of teaching that encompasses an in vivo model could impact the way a lung protective strategy could be implemented in the clinical setting.