Percentage of cases in which Positive End Expiratory Pressure (PEEP) is used for patients undergoing mechanical ventilation during anesthesia. PUL 03 will determine if PEEP was administered (as defined by median PEEP ≥ 2) and also analyze distribution of PEEP levels:
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 and use of PEEP.1-6 Unfortunately, there is not enough evidence to suggest specific PEEP levels. Therefore, specific threshold indicators will not be defined for PUL 03 initially.
Case start to case end (see other measure build details)
Patients undergoing endotracheal intubation.
Median PEEP ≥ 2 cm H2O (Assuming values less than 2 cm H2O is equivalent to no PEEP administered) for the time period between Case Start and Case End.
Algorithm for determining Measure Start/End Times:
Measure Start Time:
Measure End Time:
This measure is informational only. Attribution not yet determined by the MPOG Quality Committee.
PEEP, PIP, Tidal Volume
|Date Reviewed||QC Presentation||Reviewer||Institution||Summary||QC Vote|
Joel Kileny, MD
Trinity Health - Ann Arbor