RESULTS: We collected service demographics, tidal volume sizes, modes of ventilation and oxygenation indices. Additionally, mortality was evaluated for each group and sub-group. All data were calculated and compared between phase one and phase two. Use of tidal volumes > 8ml/kg/pbw was (63%) phase one, (29%) phase two (p <.001), Tidal volumes ≥ 6ml and ≤ 8ml (34%) phase one, (63%) phase two (p <.001). The use of Pressure Regulated Volume Control (PRVC) was utilized in (77%) of patients phase one, and (18%) phase two (p <.001). Volume Controlled Ventilation was used in (5%) of patients phase one and (74%) Phase two (p <0.001). Acuity levels as they relate to respiratory failure were assigned by determining the number of patients that had a P/F ratio of ≤ 100. This was (4%) in phase one and (7%) in phase two (p 0.19) with mortality rates of (25%) and (64%) respectively (p < 0.05).