A survey on the practices and capabilities in the management of respiratory failure in South East England
| Autor: | Luigi Camporota, Abhishek Jha, Nicholas A Barrett, Chris Meadows, Francesco Vasques, Peter B. Sherren, Nicholas Ioannou, Andrew Retter, Barnaby Sanderson, Guy Glover, Kathleen Daly, Chris Langrish, Duncan Wyncoll, Richard Paul |
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| Rok vydání: | 2020 |
| Předmět: |
Mechanical ventilation
medicine.medical_specialty business.product_category Referral business.industry medicine.medical_treatment 030208 emergency & critical care medicine Original Articles Acute respiratory distress Critical Care and Intensive Care Medicine Critical Care Nursing 03 medical and health sciences 0302 clinical medicine 030228 respiratory system Respiratory failure Emergency medicine South east medicine Extracorporeal membrane oxygenation Respirator business |
| Zdroj: | J Intensive Care Soc |
| ISSN: | 1751-1437 |
| DOI: | 10.1177/1751143720928895 |
| Popis: | Introduction The variability of acute respiratory distress syndrome management may affect the referral practice to severe respiratory failure centres. We described the management of acute respiratory distress syndrome in our catchment area. Methods An electronic survey was administered to 42 intensive care units in South-East England. Results Response rate was 71.4%. High-flow nasal oxygen and non-invasive ventilation were used ‘often’ in moderate-acute respiratory distress syndrome by 46.7% and 60%. During invasive ventilation, 90% preferred pressure control, targeting tidal volumes of 6–8 ml/kg (53.3%) or 4–6 ml/kg (46.7%). Positive end-expiratory pressure was selected by positive end-expiratory pressure/inspiratory fraction of oxygen tables (50%) or decremental positive end-expiratory pressure trials (20%). Neuro-muscular blockers were widely used, although routinely by only 3.3%. High-frequency oscillatory ventilation (10%) and inhaled nitric oxide (13.3%) were rarely used. None used oesophageal manometry. Recruitment manoeuvres were used ‘often’ by 26.7%. Equipment (90%) and protocols (80%) for prone position were common, with sessions mostly lasting 12–18 h. Conclusions Although variable, practice well reflected the available evidence. Proning was widely practiced with good availability of educational resources and protocolised care. |
| Databáze: | OpenAIRE |
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