Aerosol therapy in intensive and intermediate care units: prospective observation of 2808 critically ill patients
Autor: | Alexis Donzeau, Arnaud Desachy, Ferran Roche-Campo, Héctor León Yoshido, Carlos Vicent, Josep Trenado-Alvarez, Laetitia Bodet-Contentin, Carlos Wilson Gomes Lopes, Metaxia Papanikolaou, Jonathan Dugernier, David Thévoz, Keyvan Razazi, Lise Piquilloud, Daniel Isabey, Karim Lakhal, Antoine Edelson, Gabriela Apiou-Sbirlea, François Vermeulen, Stephan Ehrmann, Laurent Brochard |
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Přispěvatelé: | Ehrmann, Stephan, Roche-Campo, Ferran, Bodet-Contentin, Laetitia, Razazi, Keyvan, Dugernier, Jonathan, Trenado-Alvarez, Josep, Donzeau, Alexi, Vermeulen, Françoi, Thévoz, David, Papanikolaou, Metaxia, Edelson, Antoine, León Yoshido, Héctor, Piquilloud, Lise, Lakhal, Karim, Lopes, Carlo, Vicent, Carlo, Desachy, Arnaud, Apiou-Sbirlea, Gabriela, Isabey, Daniel, Brochard, Laurent, Reva Research NetworkAT@ICU Study Group: [.., Stefano Nava, ] |
Rok vydání: | 2015 |
Předmět: |
Male
Cross-sectional study Critical Care and Intensive Care Medicine Aerosol therapy Pulmonary Disease Chronic Obstructive 0302 clinical medicine Prospective Studies Prospective cohort study Aerosolization Aged 80 and over Metered dose inhalers [MeSH] Bacterial Infections Middle Aged respiratory system Anti-Bacterial Agents Bronchodilator Agents Administration inhalation [MeSH] Breathing Female Intermediate care Anti-bacterial agents [MeSH] Human Adult medicine.medical_specialty Critical Care Bacterial Infection 03 medical and health sciences Bronchodilator agents [MeSH] Anesthesiology Anti-Bacterial Agent Administration Inhalation medicine Humans Intensive care medicine Aerosol Bronchodilator Agent Aged Cross-Sectional Studie Aerosols Critically ill business.industry Nebulizers and Vaporizers 030208 emergency & critical care medicine Nebulizers and vaporizers [MeSH] Prospective Studie Respiration artificial [MeSH] Cross-Sectional Studies 030228 respiratory system Emergency medicine business Nebulizers and Vaporizer |
Zdroj: | Intensive Care Medicine. 42:192-201 |
ISSN: | 1432-1238 0342-4642 |
Popis: | Purpose: Unlike in the outpatient setting, delivery of aerosols to critically ill patients may be considered complex, particularly in ventilated patients, and benefits remain to be proven. Many factors influence aerosol delivery and recommendations exist, but little is known about knowledge translation into clinical practice. Methods: Two-week cross-sectional study to assess the prevalence of aerosol therapy in 81 intensive and intermediate care units in 22 countries. All aerosols delivered to patients breathing spontaneously, ventilated invasively or noninvasively (NIV) were recorded, and drugs, devices, ventilator settings, circuit set-up, humidification and side effects were noted. Results: A total of 9714 aerosols were administered to 678 of the 2808 admitted patients (24 %, CI95 22–26 %), whereas only 271 patients (10 %) were taking inhaled medication before admission. There were large variations among centers, from 0 to 57 %. Among intubated patients 22 % (n = 262) received aerosols, and 50 % (n = 149) of patients undergoing NIV, predominantly (75 %) inbetween NIV sessions. Bronchodilators (n = 7960) and corticosteroids (n = 1233) were the most frequently delivered drugs (88 % overall), predominantly but not exclusively (49 %) administered to patients with chronic airway disease. An anti-infectious drug was aerosolized 509 times (5 % of all aerosols) for nosocomial infections. Jet-nebulizers were the most frequently used device (56 %), followed by metered dose inhalers (23 %). Only 106 ( |
Databáze: | OpenAIRE |
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