Related Experiment Video
Updated: Aug 19, 2026

Ex Vivo Porcine Experimental Model for Studying and Teaching Lung Mechanics
Published on: April 19, 2024
Feedback and education improve physician compliance in use of lung-protective mechanical ventilation
Esther K Wolthuis1, Johanna C Korevaar, Peter Spronk
1Department of Intensive Care Medicine, Academic Medical Center, Meibergdreef 9, 1105 AZ Amsterdam, The Netherlands. e.k.wolthuis@amc.uva.nl
Objective:
Use of lung-protective mechanical ventilation (MV) by applying lower tidal volumes is recommended in patients suffering from acute lung injury (ALI) or acute respiratory distress syndrome (ARDS). Recent data suggest that lung-protective MV may benefit non-ALI/ARDS patients as well. This study analyzed tidal volume settings in three ICUs in The Netherlands to determine the effect of feedback and education concerning use of lung-protective MV.
Design And Setting:
Observational study in one academic and two nonacademic "closed format" ICUs.
Patients:
Intubated mechanically ventilated subjects.
Interventions:
Feedback and education concerning lung-protective MV with special attention to the importance of closely adjusting tidal volumes to predicted body weight (PBW).
Results:
Tidal volumes declined significantly within 6 months after intervention (from 9.8+/-2.0 at baseline to 8.1+/-1.7 ml/kg PBW) as the percentage of undesirable ventilation data points, defined as tidal volumes greater than 8 ml/kg PBW (84% vs. 48%). There were no differences between patients meeting the international definition criteria for ALI/ARDS and those not. Only four patients received tidal volumes less than 6 ml/kg PBW. Lower tidal volumes were still used after 12 months. Tidal volumes in patients on mandatory MV and patients breathing on spontaneous modes were similar.
Conclusions:
Feedback and education improve physician compliance in use of lung-protective MV.
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