Patients with acute lung injury (ALI) have a significantly higher survival rate if they are treated by board-certified critical care physicians instead of just any attending physician, according to the October issue of the American Journal of Respiratory and Critical Care Medicine.

ALI is a serious inflammatory condition usually accompanying pneumonia or sepsis with mortality rates that sometimes exceed 40%.

In the study, two thirds of the patients were treated at “closed” ICUs—units that require cases to be managed by board-certified critical care physicians. The remaining third received care at “open” ICUs, where cases could be managed by any attending physician. According to the American College of Chest Physicians, “only 25% of ICUs nationwide follow the closed model.”

The researchers, led by Miriam Treggiari, MD, MPH, of the Harborview Medical Center at the University of Washington and lead author of the study, observed that low tidal volume mechanical ventilation differed between closed and open ICUs, supporting the idea of greater positive patient outcomes in the closed-model ICU.

Said Treggiari, “Further studies will need to investigate if the beneficial effects of closed ICU derive from higher degree of staffing that could facilitate earlier recognition of critical/deteriorating conditions or greater expertise in the specific management aspects of critical care patients.”