This measure is calculated based on data extracted from the electronic medical record combined with administrative data sources such as professional fee and discharge diagnoses data. This measure is explicitly not based on provider self-attestation.
Percentage of cases with median tidal volumes less than or equal to 8 ml/kg.
Case Start to Case End (see other measure build details)
Patients undergoing endotracheal intubation.
Median tidal volume ≤ 8 ml/ kg predicted body weight for the time period between Case Start and Case End.
Algorithm for determining Case Duration
Case Start:
Case End:
Provider signed in for largest portion of case. See ‘Other Measure Build Details’ section of this specification to view the algorithm used for determining case duration.
Method for determining Responsible Provider:
In the event that two or more providers in the same class are signed in for the same duration, all providers signed in for the longest duration will be attributed.
Endotracheal Tube
|
Tidal Volume
|
One-Lung Ventilation |
Predicted Body Weight |
||||
50121 |
Intubation Endotracheal Tube Stylet Used |
3190 |
Tidal Volume Actual |
50501 |
Thoracic-Single lung ventilation |
70257 |
Physical Exam- Height (cm) |
50122 |
Intubation Endotracheal Tube Size |
3192 |
Tidal Volume Set |
50202 |
Thoracic-Single lung ventilation side detail |
70258 |
Physical Exam- Height (in) |
50123 |
Intubation Endotracheal Tube Type |
3185 |
Peak Inspiratory Pressure |
Intraoperative Medication |
Administration
|
||
50124 |
Intubation Endotracheal Tube Secured Mechanism |
3210 |
Positive End Expiratory Pressure- Measured |
10473 |
Epoprostenol |
2006 |
Inhalational |
50125 |
Intubation Endotracheal Tube Secured Distance |
3212 |
Positive End Expiratory Pressure- Set |
|
|||
50126 |
Intubation Endotracheal Tube Secured Reference Point |
|
|||||
50202 |
Emergence- Patient Extubated |
|
|||||
50205 |
Intubation Tube Note |
|
|||||
50671 |
Intubation- endotracheal tube in situ |
|
The use of lung protective ventilation techniques (low tidal volumes and positive end-expiratory pressure) should be part of standard anesthetic practice for most cases that require positive pressure ventilation. Several randomized controlled trials, as well as a meta-analysis in 2015 describe the benefit with low vs high tidal volume techniques.1-6