Methods: A retrospective observational design was used to explore relationships between monitoring
intensity, therapeutic intervention intensity, and compliance with a lung protective philosophy of mechanical
ventilation in a cohort of patients with ARDS or ALI. Compliance with lung protective targets
was measured as the proportion of time oxygen saturation, alveolar distending pressure, and tidal volume
were maintained within recommended guidelines as evidenced by medical record documentation.
Monitoring intensity and therapeutic intervention intensity were based on the frequency of recorded
assessments and interventions in the medical record.