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

Autor:	Nadeem RN; Intensive Care Medicine, Dubai Hospital, Dubai, ARE., Elhoufi AM; Intensive Care Medicine, Dubai Hospital, Dubai, ARE., Soliman MA; Intensive Care Medicine, Dubai Hospital, Dubai, ARE., Bon I; Intensive Care Medicine, Dubai Hospital, Dubai, ARE., Obaida ZA; Intensive Care Medicine, Dubai Hospital, Dubai, ARE., Hussien MM; Intensive Care Medicine, Dubai Hospital, Dubai, ARE., Salama L; Intensive Care Medicine, Dubai Hospital, Dubai, ARE., Elsousi AN; Intensive Care Medicine, Dubai Hospital, Dubai, ARE., Kamat S; Intensive Care Medicine, Dubai Hospital, Dubai, ARE., Satti RM; Intensive Care Medicine, Dubai Hospital, Dubai, ARE., Elahi N; Intensive Care Medicine, Dubai Hospital, Dubai, ARE., Abuhijleh RH; Intensive Care Medicine, Dubai Hospital, Dubai, ARE., ElZeiny MG; Intensive Care Medicine, Dubai Hospital, Dubai, ARE., Fargaly H; Intensive Care Medicine, Dubai Hospital, Dubai, ARE., Ibrahim MM; Intensive Care Medicine, Dubai Hospital, Dubai, ARE.
Jazyk:	angličtina
Zdroj:	Cureus [Cureus] 2019 Jun 06; Vol. 11 (6), pp. e4844. Date of Electronic Publication: 2019 Jun 06.
DOI:	10.7759/cureus.4844
Abstrakt:	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. Competing Interests: The authors have declared that no competing interests exist.
Databáze:	MEDLINE
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