Clinical Predictors of Adherence to Low Tidal Volume Ventilation Practice: Is it Different on Weekend and Night Shifts?

被引：5

作者：

Nadeem, Rashid N. ^{[1
]}

Elhoufi, Ashraf M. ^{[1
]}

Soliman, Mohamed A. ^{[1
]}

Bon, Islam ^{[1
]}

Obaida, Zaineb A. ^{[1
]}

Hussien, Mayada M. ^{[1
]}

Salama, Lamiaa ^{[1
]}

Elsousi, Ahmed N. ^{[1
]}

Kamat, Sahish ^{[1
]}

Satti, Rami M. ^{[1
]}

Elahi, Naheed ^{[1
]}

Abuhijleh, Raed H. ^{[1
]}

ElZeiny, Moatz G. ^{[1
]}

Fargaly, Hitham ^{[1
]}

Ibrahim, Mohamed M. ^{[1
]}

机构：

[1] Dubai Hosp, Intens Care Med, Dubai, U Arab Emirates

来源：

CUREUS JOURNAL OF MEDICAL SCIENCE | 2019年 / 11卷 / 06期

关键词：

low tidal volume ventilation; hypoxemia; lung protective ventilation; acute lung injury; adherence; hypercapnia; outcomes; shifts; RESPIRATORY-DISTRESS-SYNDROME; LUNG-PROTECTIVE VENTILATION; MORTALITY; HYPERCAPNIA; INJURY; PEEP;

D O I：

10.7759/cureus.4844

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

Background: Low tidal volume ventilation (LTVV) strategy improves outcomes; however, despite recommended by guidelines, adherence to this practice is not high. Methods: Tidal volume for mechanically ventilated patients were recorded for each 12-hour shift, day and night shifts for consecutive 101 patients. Adherence was determined by comparing these tidal volumes to standard low tidal volumes of 6 ml/kg of ideal body weight. Adherence rates were calculated and adherence rates of daytime shifts were compared to those of night time shifts. Adherence rates for weekday shifts were compared with those of weekend shifts. Clinical variables were recorded to analyze predictors of adherence pattern. Results: The sample size was 101 patients with 870 patient-ventilator days with 1734 patient ventilator shifts. Shift adherence was only 47.5%. There was no significant difference between day and night shifts or weekday and weekend shifts. Stepwise multiple regression analysis shows that age, gender, body mass index (BMI), and partial pressure of carbon dioxide (PCO2) have significant correlation with adherence to LTVV practice. Conclusion: The study found that adherence to lung protective low tidal volume mechanical ventilation practice is low. Practice adherence is not different over weekend or night shifts. Age, gender, BMI, and PCO2 have significant correlation with adherence to LTVV practice.

引用

页数：7

共 23 条

[1]

[Anonymous], 1999, Am. J. Respir. Crit. Care Med, V160, P2118, DOI DOI 10.1164/AJRCCM.160.6.ATS16060

[2] Incidence, risk factors and outcome of barotrauma in mechanically ventilated patients [J].

Anzueto, A ;

Frutos-Vivar, F ;

Esteban, A ;

Alía, I ;

Brochard, L ;

Stewart, T ;

Benito, S ;

Tobin, MJ ;

Elizalde, J ;

Palizas, F ;

David, CM ;

Pimentel, J ;

González, M ;

Soto, L ;

D'Empaire, G ;

Pelosi, P .

INTENSIVE CARE MEDICINE, 2004, 30 (04) :612-619

[3] Ventilation with lower tidal volumes as compared with traditional tidal volumes for acute lung injury and the acute respiratory distress syndrome. [J].

Brower, RG ;

Matthay, MA ;

Morris, A ;

Schoenfeld, D ;

Thompson, BT ;

Wheeler, A ;

Wiedemann, HP ;

Arroliga, AC ;

Fisher, CJ ;

Komara, JJ ;

Perez-Trepichio, P ;

Parsons, PE ;

Wolkin, R ;

Welsh, C ;

Fulkerson, WJ ;

MacIntyre, N ;

Mallatratt, L ;

Sebastian, M ;

McConnell, R ;

Wilcox, C ;

Govert, J ;

Thompson, D ;

Clemmer, T ;

Davis, R ;

Orme, J ;

Weaver, L ;

Grissom, C ;

Eskelson, M ;

Young, M ;

Gooder, V ;

McBride, K ;

Lawton, C ;

d'Hulst, J ;

Peerless, JR ;

Smith, C ;

Brownlee, J ;

Pluss, W ;

Kallet, R ;

Luce, JM ;

Gottlieb, J ;

Elmer, M ;

Girod, A ;

Park, P ;

Daniel, B ;

Gropper, M ;

Abraham, E ;

Piedalue, F ;

Glodowski, J ;

Lockrem, J ;

McIntyre, R .

NEW ENGLAND JOURNAL OF MEDICINE, 2000, 342 (18) :1301-1308

[4] GENTAMICIN THERAPY [J].

DEVINE, BJ .

DRUG INTELLIGENCE & CLINICAL PHARMACY, 1974, 8 (11) :650-655

[5]

Doelken P, 2008, INTENS CARE MED, P636

[6] An Official American Thoracic Society/European Society of Intensive Care Medicine/Society of Critical Care Medicine Clinical Practice Guideline: Mechanical Ventilation in Adult Patients with Acute Respiratory Distress Syndrome [J].

Fan, Eddy ;

Del Sorbo, Lorenzo ;

Goligher, Ewan C. ;

Hodgson, Carol L. ;

Munshi, Laveena ;

Walkey, Allan J. ;

Adhikari, Neill K. J. ;

Amato, Marcelo B. P. ;

Branson, Richard ;

Brower, Roy G. ;

Ferguson, Niall D. ;

Gajic, Ognjen ;

Gattinoni, Luciano ;

Hess, Dean ;

Mancebo, Jordi ;

Meade, Maureen O. ;

McAuley, Daniel F. ;

Pesenti, Antonio ;

Ranieri, V. Marco ;

Rubenfeld, Gordon D. ;

Rubin, Eileen ;

Seckel, Maureen ;

Slutsky, Arthur S. ;

Talmor, Daniel ;

Thompson, B. Taylor ;

Wunsch, Hannah ;

Uleryk, Elizabeth ;

Brozek, Jan ;

Brochard, Laurent J. .

AMERICAN JOURNAL OF RESPIRATORY AND CRITICAL CARE MEDICINE, 2017, 195 (09) :1253-1263

[7] PERMISSIVE HYPERCAPNIA - HOW PERMISSIVE SHOULD WE BE [J].

FEIHL, F ;

PERRET, C .

AMERICAN JOURNAL OF RESPIRATORY AND CRITICAL CARE MEDICINE, 1994, 150 (06) :1722-1737

[8] Intrinsic positive end-expiratory pressure in Acute Respiratory Distress Syndrome (ARDS) Network subjects [J].

Hough, CL ;

Kallet, RH ;

Ranieri, VM ;

Rubenfeld, GD ;

Luce, JM ;

Hudson, LD .

CRITICAL CARE MEDICINE, 2005, 33 (03) :527-532

[9] Pulmonary Manifestations of Acute Lung Injury More Than Just Diffuse Alveolar Damage [J].

Hughes, Kenneth T. ;

Beasley, Mary Beth .

ARCHIVES OF PATHOLOGY & LABORATORY MEDICINE, 2017, 141 (07) :916-922

[10]

Kavanagh BP, 2006, MINERVA ANESTESIOL, V72, P567

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