Patient-Ventilator Asynchrony in Critical Care Settings: National Outcomes of Ventilator Waveform Analysis

Alqahtani, Jaber S; AlAhmari, Mohammed D.; Alshamrani, Khalid H; Alshehri, Abdullah; Althumayri, Mashhour A; Ghazwani, Abdullah; Alamoudi, Asma O.; Alsomali, Afrah; Alenazi, Meshal H; AlZahrani, Yousef R; Alqahtani, Abdullah S; AlRabeeah, Saad M.; Arabi, Yaseen M.

doi:10.1016/j.hrtlng.2020.04.002

Cited by 9 publications

(9 citation statements)

References 35 publications

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“…[ 10 ] Close and consistent monitoring can support early detection of patient-ventilator asynchrony and other invasive and noninvasive complications. [ 21 22 23 ] These findings are compatible with the current evidence regarding ventilator check frequency. [ 24 25 ]…”

Section: Discussionsupporting

confidence: 87%

Clinical Practice and Barriers of Ventilatory Support Management in COVID-19 Patients in Saudi Arabia

Alqahtani¹,

Aldabayan²,

AlAhmari³

et al. 2021

Saudi Journal of Medicine &Amp; Medical Sciences

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Objective: This study was conducted to determine the clinical practice and barriers of ventilatory support management in COVID-19 patients in Saudi Arabia among respiratory therapists. Methods: A validated questionnaire comprising three parts was distributed to all critical care respiratory therapists registered with the Saudi Society for Respiratory Care through the official social networks. Results: A total of 74 respiratory therapists completed the survey. The mean (±standard deviation) of intensive care unit beds was 67 ± 79. Clinical presentation (54%) and arterial blood gas (38%) were the two main diagnostic tools used to initiate ventilatory support. While protocols for the initiation of invasive mechanical ventilation (IMV; 81%) were widely available, participants had limited availability of protocols for the use of non-invasive ventilation (NIV; 34%) and high-flow nasal cannula (HFNC; 34%). In mild cases of COVID-19, most respondents used HFNC (57%), while IMV was mostly used in moderate (43%) and severe (93%) cases. Regular ventilator check was mostly done every 4 h (57%). BiPAP (47.3%) and full-face masks (45.9%) were the most used mode and interface, respectively, while pressure-regulated volume control (55.4%) and pressure control (27%) were the most used mechanical ventilation modes for COVID-19 patients. In terms of use of proning, 62% used it on IMV, while 26% reported using awake proning. Staff shortage (51.4%), personal protective equipment (PPE) shortage (51.4%), increased workload (45.9%), inadequate training (43.2%) and lack of available protocols and policies (37.8%) were the main barriers. Conclusion: Ventilatory support management of COVID-19 in Saudi Arabia was inconsistent with the global practice, lacked uniformity, and there was limited use of standard protocols/treatment guidelines. Shortage of staff and PPE, increased workload and insufficient training were the most prevalent barriers.

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Section: Discussionsupporting

confidence: 87%

Clinical Practice and Barriers of Ventilatory Support Management in COVID-19 Patients in Saudi Arabia

Alqahtani¹,

Aldabayan²,

AlAhmari³

et al. 2021

Saudi Journal of Medicine &Amp; Medical Sciences

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“…Mismanagement of ventilatory support due to lack of training could lead to further complications, including ventilator-associated pneumonia, patient-ventilator asynchrony and barotrauma. 16,17 Global emergency strategies to maximise the capacity of the health care workforce, such as relaxing staffing requirements and redeploying health workers to high-need areas, could further exacerbate the problem if proper rapid training mechanisms are not in place. 18 Most of the responses came from respiratory therapists, physiotherapists, and intensivists.…”

Section: Discussionmentioning

confidence: 99%

<p>Global Current Practices of Ventilatory Support Management in COVID-19 Patients: An International Survey</p>

Alqahtani¹,

Mendes²,

Aldhahir³

et al. 2020

JMDH

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“…Eine vor Kurzem veröffentlichte Studie konnte zeigen, dass etwa ein Viertel der Asynchronien vom medizinischen Personal nicht erkannt wurden. Prädiktoren des Personals für die Fähigkeit dieser Detektion waren dabei weibliches Geschlecht und vorheriges Training [2]. Eine Pilotstudie konnte zeigen, dass die Detektion von Patient-Ventilator-Asynchronien auch automatisiert werden kann [3].…”

Section: Einführung In Die Gerätetechnikunclassified

Technische Aspekte und Neuerungen in der nicht-invasiven und invasiven Beatmung

Dellweg,

Lepper

2024

Pneumologie

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Zusammenfassung Nicht-invasive und invasive Beatmung sind für die Therapie bei akuter und chronischer respiratorischer Insuffizienz unerlässlich geworden. Mehr als ein Drittel der Patienten auf Intensivstationen wird invasiv beatmet, und auch in der außerklinischen Beatmung nimmt die Zahl beatmeter Patienten stetig zu. Während die Normalisierung der Blutgase in vergangenen Jahrzehnten als bedeutsamstes Ziel angesehen wurde und der Gedanke, dass mechanische Beatmung auch Gefahren birgt, kaum eine Rolle spielte, ist der dominierende Gedanke derzeit die Applikation von Beatmung unter möglichst protektiven Gesichtspunkten. Da eine grundlegende Änderung der Gerätetechnik schwierig sein dürfte, wird die Verbesserung protektiver Beatmung und eine Weiterentwicklung des Verständnisses der pathophysiologischen Vorgänge bei akutem und chronischem Lungenversagen auch in der Zukunft eine große Bedeutung haben. Der Artikel fasst unterschiedliche Aspekte der technischen Grundlagen der nicht-invasiven und invasiven Beatmung und deren praktische Umsetzung zusammen.

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Patient-Ventilator Asynchrony in Critical Care Settings: National Outcomes of Ventilator Waveform Analysis

Cited by 9 publications

References 35 publications

Clinical Practice and Barriers of Ventilatory Support Management in COVID-19 Patients in Saudi Arabia

Clinical Practice and Barriers of Ventilatory Support Management in COVID-19 Patients in Saudi Arabia

<p>Global Current Practices of Ventilatory Support Management in COVID-19 Patients: An International Survey</p>

Technische Aspekte und Neuerungen in der nicht-invasiven und invasiven Beatmung

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