Potential reasons why physicians underuse lung-protective ventilation: a retrospective cohort study using physician documentation.

Background: Physicians often fail to use lung-protective ventilation (LPV) in patients with acute lung injury.

Objective: To use physician documentation to identify why physicians did not initiate or continue LPV in patients with acute lung injury.

Methods: This was a retrospective cohort study in a university hospital.

Underuse of lung protective ventilation: analysis of potential factors to explain physician behavior.

Objective: To determine the frequency of use of low-tidal-volume ventilation in appropriate patients with acute lung injury (ALI) and the factors associated with the choice of tidal volume.

Design: Prospective observational cohort study of patients identified with ALI or acute respiratory distress syndrome from September 2000 to November 2002.

Setting: Medical and surgical intensive care unit (ICU) at an academic tertiary-care hospital.