Respiratory failure requiring mechanical ventilation in critically ill adults in Ghana: A prospective observational study

Osei‐Ampofo, Maxwell; Aidoo, Alfred J.; Antwi-Kusi, Akwasi; Ofungwu, Obiageli Joan; Kotey, Solomon N.K.; Siaw-Frimpong, Moses; Chiedozie, Osuoji; Tafoya, Matthew J.; Becker, Torben K.

doi:10.1016/j.afjem.2018.08.001

Cited by 7 publications

(6 citation statements)

References 10 publications

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“…In this study, most clinicians preferred the use of low tidal volumes in the ventilator management of ARDS in the ICU, which is a safe and widely accepted standard practice supported by many studies such as Brower et al [16], Walkey et al [19], Papazian et al [20]. Unsurprisingly, a study conducted at Komfo Anokye Teaching Hospital (KATH) by Osei-Ampofo et al [21], where low tidal volume ventilation was not practised, recorded high mortality among patients with ARDS. The effectiveness of non-invasive ventilation in ARDS has been found to decrease with increasing severity of the disease.…”

Section: Clinicians' Practicesmentioning

confidence: 92%

Management of Acute Respiratory Distress Syndrome (ARDS): clinicians' knowledge and practice

BROBBEY,

ANING,

DJAGBLETEY

et al. 2023

HSI Journal

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Background: Acute Respiratory Distress Syndrome (ARDS) is common in the Intensive Care Unit (ICU) setting and is associated with high mortality. Delayed diagnosis and failure to institute evidenced-based management have been associated with poor outcomes. Knowledge of the diagnostic criteria for ARDS and the adoption of recommended management practices by clinicians in the ICU is therefore required to reduce mortality. Objective: This study sought to assess the knowledge and current management practices of ARDS among clinicians in a surgical ICU of the Korle-Bu Teaching Hospital. Methods: This was a cross-sectional study involving a purposive sample of 15 clinicians (Specialist Anaesthesiologists) who work at the Korle-Bu Teaching Hospital Surgical ICU. A self-administered structured questionnaire was used to obtain data on the sociodemographic characteristics, knowledge and management practices of clinicians on ARDS. Clinicians' knowledge and management practices were scored based on conformity with the ARDSnet Ventilatory Protocol. Categorical data were summarised as frequencies and proportions, and continuous data as Mean ± standard deviation. Results: Clinicians (Specialist Anaesthesiologists) had good knowledge about ARDS (Mean knowledge score = 21.00±3.87),and their management practices were above average (Mean practice score = 8.53±2.50). The clinicians rarely (40%) or never (60%) practised prone ventilation. Conclusion: Specialist Anaesthesiologists had good clinical knowledge of ARDS and applied appropriate management strategies. However, prone ventilation was rarely adopted

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Section: Clinicians' Practicesmentioning

confidence: 92%

Management of Acute Respiratory Distress Syndrome (ARDS): clinicians' knowledge and practice

BROBBEY,

ANING,

DJAGBLETEY

et al. 2023

HSI Journal

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“…Two other articles [22,27] reported that the lack of resources sometimes forces a classification decision to be made on which patients are most likely to survive to the start of mechanical ventilation. This accurately reflects the realities of intensive care and emergency in a resource-limited setting.…”

Section: Optimization Of Resources In Patients With Ards In Emergency...mentioning

confidence: 99%

Evolution of Acute Respiratory Distress Syndrome in Emergency and Critical Care: Therapeutic Management before and during the Pandemic Situation

et al. 2022

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Background and Objectives: Acute respiratory distress syndrome is a life-threatening lung condition that prevents enough oxygen from getting to the lungs and blood. The causes can be varied, although since the COVID-19 pandemic began there have been many cases related to this virus. The management and evolution of ARDS in emergency situations in the last 5 years was analyzed. Materials and Methods: A systematic review was carried out in the PubMed and Scopus databases. Using the descriptors Medical Subject Headings (MeSH), the search equation was: “Emergency health service AND acute respiratory distress syndrome”. The search was conducted in December 2021. Quantitative primary studies on the care of patients with ARDS in an emergency setting published in the last 5 years were included. Results: In the initial management, adherence to standard treatment with continuous positive airway pressure (CPAP) is recommended. The use of extracorporeal membrane reduces the intensity of mechanical ventilation or as rescue therapy in acute respiratory distress syndrome (ARDS). The prone position in both intubated and non-intubated patients with severe ARDS is associated with a better survival of these patients, therefore, it is very useful in these moments of pandemic crisis. Lack of resources forces triage decisions about which patients are most likely to survive to start mechanical ventilation and this reflects the realities of intensive care and emergency care in a resource-limited setting. Conclusions: adequate prehospital management of ARDS and in emergency situations can improve the prognosis of patients. The therapeutic options in atypical ARDS due to COVID-19 do not seem to vary substantially from conventional ARDS.

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“…8 However, prone position ventilation (PPV) can greatly promote alveolar recruitment and improve pulmonary ventilatory function, and more than 80% of patients can benefit significantly. 9,10 PPV can change the thoracic pressure gradient and thus correct the abnormal distribution of lung lesions.…”

Section: Introductionmentioning

confidence: 99%

“…However, long‐term supine position ventilation (SuPV) can quickly induce gravitational alveolar collapse, causing compressive atelectasis and pulmonary oedema, aggravating hypoxemia 8 . However, prone position ventilation (PPV) can greatly promote alveolar recruitment and improve pulmonary ventilatory function, and more than 80% of patients can benefit significantly 9,10 . PPV can change the thoracic pressure gradient and thus correct the abnormal distribution of lung lesions.…”

Section: Introductionmentioning

confidence: 99%

Prone position ventilation for the relief of acute respiratory distress syndrome through improved pulmonary ventilation: Efficacy and safety

Liao

Meng

Zeng

2023

Nursing in Critical Care

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BackgroundAt present, there is a preliminary clinical consensus that prone position ventilation (PPV) is beneficial to the treatment of acute respiratory distress syndrome (ARDS), and further research on the details of treatment and patients' benefits will help to assess its effectiveness and safety.AimsTo evaluate the timing, efficacy, and safety of different mechanical ventilation positions (MVP) in treating ARDS.DesignThe results of clinical trials were directly or indirectly compared by network meta‐analysis to compare the effects of different MVP.MethodTwo authors independently searched the papers published in PubMed, Embase, Cochrane Library, China Knowledge Infrastructure (CNKI), China Biomedical Discs (CBM), WanFang, and VIP database from January 2000 to August 2022. The outcome indicators were oxygenation index, mechanical ventilation time, ICU hospitalization time, in‐hospital mortality, and incidence of adverse events. Two authors independently screened the literature, evaluated the quality of the studies, and completed the data extraction. Stata 14.0 was used to conduct a network Meta‐analysis, and the intervention measures were ranked according to the surface under the cumulative ranking curve (SUCRA). Funnel plots were drawn to evaluate publication bias.ResultsAccording to the inclusion and exclusion criteria, 75 studies (including 6333 patient data) were finally included. According to the analysis results, PPV was the best for improving the oxygenation index. The SUCRA values of mechanical ventilation time, ICU hospitalization time, and in‐hospital mortality were ranked as PPV > lateral position ventilation (LPV) > supine position ventilation (SuPV) > semireclining position ventilation (SePV). The SUCRA values in the incidence of adverse events were ranked as LPV > PPV > SuPV > SePV. All outcome measures had good consistency and low statistical heterogeneity. Funnel plot analysis shows that papers reported within three days of mechanical ventilation time, over five days of mechanical ventilation time, and in‐hospital mortality were more likely to have publication bias.ConclusionsPPV has the best effect on improving the oxygenation index, reducing mechanical ventilation time, shortening ICU hospitalization time, and reducing in‐hospital mortality. Early and long‐term use of PPV to improve pulmonary ventilatory function will be the key to improving patients' survival and quality of life with ARDS.Relevance to clinical practicePPV significantly affects patients with ARDS, which can shorten the treatment time and reduce hospital costs. During the treatment, nursing observation should be strengthened to prevent adverse events.

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Respiratory failure requiring mechanical ventilation in critically ill adults in Ghana: A prospective observational study

Cited by 7 publications

References 10 publications

Management of Acute Respiratory Distress Syndrome (ARDS): clinicians' knowledge and practice

Management of Acute Respiratory Distress Syndrome (ARDS): clinicians' knowledge and practice

Evolution of Acute Respiratory Distress Syndrome in Emergency and Critical Care: Therapeutic Management before and during the Pandemic Situation

Prone position ventilation for the relief of acute respiratory distress syndrome through improved pulmonary ventilation: Efficacy and safety

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