Date of Award

Spring 5-7-2021

Document Type

DNP Project

Project Team Faculty Member

Rebecca Collier DNP, CRNA, APRN

Project Team Faculty Member



intraoperative lung-protective ventilation, pediatric, PEEP, recruitment maneuvers, tidal volume, hyperoxia


Traditional ventilation strategies have been shown to lead to the development of lung injury and postoperative pulmonary complications. Lung-protective ventilation (LPV) strategies for adults include low tidal volumes of 6-8 mL/kg based on ideal body weight, moderate levels of positive end-expiratory pressure (PEEP), incremental recruitment maneuvers routinely and as needed, and low fraction of inspired oxygen. Recommendations for pediatrics are similar, with some suggesting a more liberal limit for tidal volumes of less than 10 mL/kg based on predicted body weight. However, adoption of LPV strategies is not universal. Completed objectives of this practice project included thoroughly reviewing literature relating to contemporary intraoperative LPV strategies, synthesis of findings into a list of recommendations, presentation of these recommendations to anesthesia providers at the host facility, programming new recruitment maneuver functions into facility ventilators, and providing a laminated infographic to encourage compliance. After the presentation, 20 staff members voluntarily completed an anonymous questionnaire. Results indicated the educational presentation increased provider knowledge of LPV, and most respondents expressed willingness to support implementation of the strategies. Additionally, a large majority of respondents reported confidence that implementing LPV strategies would improve patient outcomes.

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