Specific Training Improves the Detection and Management of Patient-Ventilator Asynchrony

被引:4
作者
Ramirez, Ivan I. [1 ,2 ,3 ,4 ,18 ]
Gutierrez-Arias, Ruvistay [1 ,4 ,5 ]
Damiani, L. Felipe [6 ]
Adasme, Rodrigo S. [5 ,7 ]
Arellano, Daniel H. [3 ]
Salinas, Francisco A. [4 ,8 ]
Roncalli, Angelo [9 ]
Nunez-Silveira, Juan [10 ]
Santillan-Zuta, Milton [11 ,12 ]
Sepulveda-Barisich, Patrick [13 ]
Gordo-Vidal, Federico [14 ,15 ,17 ]
Blanch, Lluis [16 ]
机构
[1] Inst Nacl Torax, Dept Apoyo Rehabil Cardiopulmonar Integral, Santiago, Chile
[2] Diego Portales Univ, Fac Hlth Sci, Santiago, Chile
[3] Hosp Clin Univ Chile, Div Crit Care Med, Santiago, Chile
[4] INTRehab Res Grp, Santiago, Chile
[5] Univ Andres Bello, Exercise & Rehabil Sci Inst, Fac Rehabil Sci, Santiago, Chile
[6] Pontificia Univ Catolica Chile, Fac Med, Dept Ciencias salud Carrera Kinesiologia Kinesiol, Santiago, Chile
[7] Pontificia Univ Catolica Chile, Hosp Clin Red Salud Christus UC, Div Pediat Crit Care Med, Santiago, Chile
[8] Univ Autonoma Chile, Fac Ciencias Salud, Santiago, Chile
[9] Univ Estadual Ciencias Saude, Maceio, Brazil
[10] Hosp Italiano Buenos Aires, Div Crit Care Med, Buenos Aires, Argentina
[11] Hosp Nacl Guillermo Almenara, Crit Care Dept, Lima, Peru
[12] Univ Nacl Toribio Rodriguez Mendoza, Fac Argentina Hlth Sci, Amazonas, Peru
[13] La Serena Hosp, Serv Med Fis & Rehabil, La Serena, Chile
[14] Hosp Univ Henares, Intens Care Dept, Coslada, Madrid, Spain
[15] Univ Francisco Vitoria, Fac Med, Grp Invest Patologia Crit, Pozuelo De Alarcon, Madrid, Spain
[16] Univ Autonoma Barcelona, Parc Tauli Hosp Univ, Inst Invest & Innovacio Parc Tauli I3PT, Crit Care Ctr, Sabadell, Spain
[17] Inst Salud Carlos III, Ctr Invest Biomed Red Enfermedades Respiratorias, Madrid, Spain
[18] Diego Portales Univ, Fac Hlth Sci, Manuel Rodriguez 415, Santiago 8331015, Chile
关键词
mechanical ventilation; intensive care unit; patient-ventilator interaction; patient-ventilator asynchrony; critically ill patient; critical care; MECHANICAL VENTILATION; AUTOMATIC DETECTION; INEFFECTIVE EFFORTS; IMPACT; FLOW;
D O I
10.4187/respcare.11329
中图分类号
R4 [临床医学];
学科分类号
1002 ; 100602 ;
摘要
BACKGROUND: Patient -ventilator asynchrony is common in patients undergoing mechanical ventilation. The proportion of health-care professionals capable of identifying and effectively managing different types of patient -ventilator asynchronies is limited. A few studies have developed specific training programs, but they mainly focused on improving patient -ventilator asynchrony detection without assessing the ability of health-care professionals to determine the possible causes. METHODS: We conducted a 36-h training program focused on patient -ventilator asynchrony detection and management for health-care professionals from 20 hospitals in Latin America and Spain. The training program included 6 h of a live online lesson during which 120 patient -ventilator asynchrony cases were presented. After the 6-h training lesson, health-care professionals were required to complete a 1-h training session per day for the subsequent 30 d. A 30 -question assessment tool was developed and used to assess health-care professionals before training, immediately after the 6-h training lecture, and after the 30 d of training (1 -month follow-up).RESULTS: One hundred sixteen health-care professionals participated in the study. The median (interquartile range) of the total number of correct answers in the pre -training, post -training, and 1 -month follow-up were significantly different (12 [8.75-15], 18 [13.75-22], and 18.5 [14-23], respectively). The percentages of correct answers also differed significantly between the time assessments. Study participants significantly improved their performance between pre -training and post -training (P < .001). This performance was maintained after a 1 -month follow-up (P 5 .95) for the questions related to the detection, determination of cause, and management of patient -ventilator asynchrony. CONCLUSIONS: A specific 36-h training program significantly improved the ability of health-care professionals to detect patient -ventilator asynchrony, determine the possible causes of patient -ventilator asynchrony, and properly manage different types of patient -ventilator asynchrony.
引用
收藏
页码:166 / 175
页数:10
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