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
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
Externí odkaz: