Mia Shokry, Melina Simonpietri, Kimiyo H. Yamasaki
Left figure: Passive patient esophageal pressure (Pes) in cmH2O on x-axis versus tidal volume in ml on y-axis. Green dashed line represents the chest wall compliance Right figure: same patient actively breathing on pressure support ventilation. (Pes) in cmH2O on x-axis versus tidal volume in ml on y-axis. Green dashed line represents the chest wall compliance. Red shaded area is the Campbell diagram representing the inspiratory work of breathing
{"title":"Calculating the work of breathing during mechanical ventilation.","authors":"Mia Shokry, Melina Simonpietri, Kimiyo H. Yamasaki","doi":"10.53097/jmv.10025","DOIUrl":"https://doi.org/10.53097/jmv.10025","url":null,"abstract":"Left figure: Passive patient esophageal pressure (Pes) in cmH2O on x-axis versus tidal volume in ml on y-axis. Green dashed line represents the chest wall compliance Right figure: same patient actively breathing on pressure support ventilation. (Pes) in cmH2O on x-axis versus tidal volume in ml on y-axis. Green dashed line represents the chest wall compliance. Red shaded area is the Campbell diagram representing the inspiratory work of breathing","PeriodicalId":73813,"journal":{"name":"Journal of mechanical ventilation","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46729526","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Ronald Sanderson, Denise Whitley, Christopher Batacan
Background Automation of mechanical ventilation allows for reduction of variation in patient management and has the potential to provide increased patient safety by strict adherence to computer driven ventilator protocols. Methods: A retrospective, observational study compared a group of 196 of general ICU patients managed exclusively on automated mechanical ventilation, adaptive support ventilation (ASV), to another group of 684 managed by usual, non-automated mechanical ventilation (No ASV). The data was collected in a unique access database designed to collect data for assessment of mechanical ventilation outcomes in a small medical center ICU. Results: The length of ventilator stay was non-significant between both groups, (81.7 ± 35.2 hours) in the ASV group; vs. (94.1 ± 35.1 hours) in the No ASV. Percent mortality was significantly less in the ASV group, 8.6% compared to 27.3% in the No ASV. Conclusion: Automated ventilation appears to be a safe ventilator strategy; however, cause effect relationships cannot be determined without further, more sophisticated studies. Keywords: Closed loop ventilation, ASV, Ventilator length of stay, Percent minute ventilation
{"title":"Automated mechanical ventilation using Adaptive Support Ventilation versus conventional ventilation including ventilator length of stay, mortality, and professional social aspects of adoption of new technology.","authors":"Ronald Sanderson, Denise Whitley, Christopher Batacan","doi":"10.53097/jmv.10021","DOIUrl":"https://doi.org/10.53097/jmv.10021","url":null,"abstract":"Background Automation of mechanical ventilation allows for reduction of variation in patient management and has the potential to provide increased patient safety by strict adherence to computer driven ventilator protocols. Methods: A retrospective, observational study compared a group of 196 of general ICU patients managed exclusively on automated mechanical ventilation, adaptive support ventilation (ASV), to another group of 684 managed by usual, non-automated mechanical ventilation (No ASV). The data was collected in a unique access database designed to collect data for assessment of mechanical ventilation outcomes in a small medical center ICU. Results: The length of ventilator stay was non-significant between both groups, (81.7 ± 35.2 hours) in the ASV group; vs. (94.1 ± 35.1 hours) in the No ASV. Percent mortality was significantly less in the ASV group, 8.6% compared to 27.3% in the No ASV. Conclusion: Automated ventilation appears to be a safe ventilator strategy; however, cause effect relationships cannot be determined without further, more sophisticated studies. Keywords: Closed loop ventilation, ASV, Ventilator length of stay, Percent minute ventilation","PeriodicalId":73813,"journal":{"name":"Journal of mechanical ventilation","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46775178","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Electrical Impedance Tomography is a rapidly evolving technology used for bedside lung imaging. Although EIT devices have been commercially available for the past decade, they are still not commonly used in everyday clinical practice. EIT has multiple benefits over standard chest imaging techniques; it is non-invasive, it can be used at bedside and it allows continuous monitoring of the patient’s condition. EIT can change the standard practice for monitoring lung function and caring for patients on mechanical ventilation. In this concise review, we will discuss the general concepts of EIT and its clinical applications. As this technology keeps developing and becomes more available for clinical use, it might revolutionize the way we practice mechanical ventilation. Additional studies need to be performed to compare its benefits to our current practice. Keywords: EIT, Mechanical ventilation, PEEP, Overdistention
{"title":"Electrical Impedance Tomography: the future of mechanical ventilation?","authors":"Melina Simonpietri, Mia Shokry, Ehab Daoud","doi":"10.53097/jmv.10024","DOIUrl":"https://doi.org/10.53097/jmv.10024","url":null,"abstract":"Electrical Impedance Tomography is a rapidly evolving technology used for bedside lung imaging. Although EIT devices have been commercially available for the past decade, they are still not commonly used in everyday clinical practice. EIT has multiple benefits over standard chest imaging techniques; it is non-invasive, it can be used at bedside and it allows continuous monitoring of the patient’s condition. EIT can change the standard practice for monitoring lung function and caring for patients on mechanical ventilation. In this concise review, we will discuss the general concepts of EIT and its clinical applications. As this technology keeps developing and becomes more available for clinical use, it might revolutionize the way we practice mechanical ventilation. Additional studies need to be performed to compare its benefits to our current practice. Keywords: EIT, Mechanical ventilation, PEEP, Overdistention","PeriodicalId":73813,"journal":{"name":"Journal of mechanical ventilation","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42594930","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
There have been a recent shortage of both critical care physicians and respiratory therapists with training in mechanical ventilation that is accentuated by the recent COVID-19 crisis. Hospitalists find themselves more often dealing with and treating critically ill patients on mechanical ventilation without specific training. The first part of this review attempted to explain and simplify some of the physiologic concepts and basics of mechanical ventilation. This second part of the review we will discuss some of the common modes used for support and weaning during mechanical ventilation and to address some of the adverse effects associated with mechanical ventilation. We understand the complexity of the subject and this review would not be a substitute of seeking appropriate counselling, further training, and medical knowledge about mechanical ventilation. Further free resources are available to help clinicians who feel uncomfortable making decisions with such technology Keywords: COPD, ARDS, Weaning, VCV, PCV, ASV, MMV, NAVA, PSV, ATC, VSV, PRVC, APRV
{"title":"Review of mechanical ventilation for the non-critical care trained practitioner. Part 2","authors":"Rebecca Shimabukuro Shimabukuro, Ehab Daoud","doi":"10.53097/jmv.10016","DOIUrl":"https://doi.org/10.53097/jmv.10016","url":null,"abstract":"There have been a recent shortage of both critical care physicians and respiratory therapists with training in mechanical ventilation that is accentuated by the recent COVID-19 crisis. Hospitalists find themselves more often dealing with and treating critically ill patients on mechanical ventilation without specific training. The first part of this review attempted to explain and simplify some of the physiologic concepts and basics of mechanical ventilation. This second part of the review we will discuss some of the common modes used for support and weaning during mechanical ventilation and to address some of the adverse effects associated with mechanical ventilation. We understand the complexity of the subject and this review would not be a substitute of seeking appropriate counselling, further training, and medical knowledge about mechanical ventilation. Further free resources are available to help clinicians who feel uncomfortable making decisions with such technology Keywords: COPD, ARDS, Weaning, VCV, PCV, ASV, MMV, NAVA, PSV, ATC, VSV, PRVC, APRV","PeriodicalId":73813,"journal":{"name":"Journal of mechanical ventilation","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49406915","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
The article by Obeidat andRandhawain this issue “Gastrointestinal complications in critical care patients and effects of mechanical ventilation on the gastrointestinal tract”1is a great reminder of this important topicand a must read for ICU clinicians. The interaction between the gastro-intestinal system and the respiratory system is a tight yet not fully understoodcomplex one, and unfortunately gets overlooked.
{"title":"Respiratory and Gastrointestinal systems; friends or foes?","authors":"Ehab Daoud","doi":"10.53097/jmv.10018","DOIUrl":"https://doi.org/10.53097/jmv.10018","url":null,"abstract":"The article by Obeidat andRandhawain this issue “Gastrointestinal complications in critical care patients and effects of mechanical ventilation on the gastrointestinal tract”1is a great reminder of this important topicand a must read for ICU clinicians. The interaction between the gastro-intestinal system and the respiratory system is a tight yet not fully understoodcomplex one, and unfortunately gets overlooked.","PeriodicalId":73813,"journal":{"name":"Journal of mechanical ventilation","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46989331","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Ventilators functions and features have evolved with the advancement of technology along with the addition of microprocessors. It is important to understand and examine the benefits and risks associated with these advanced automated modes. Adaptive Support Ventilation (ASV) is a mode that is unique to the Hamilton Medical ventilators, thereby limiting the number of clinicians who have experience with using this mode. ASV can make changes to respiratory rate and tidal volume and adjusting the driving pressure in the absence of a professional. ASV changes ventilator strategies when it detects changes to a patient’s lung dynamics. The scope of ASV mode is not universally understood. Respiratory therapists may feel their position would be threatened with the use of smart automated modes. This paper will aim to review the literature on the ASV mode of ventilation. The literature review will address the following research questions to broaden the understanding of the risks and benefits of the ASV mode. 1) Is the ASV mode effective for weaning patients? 2) Is ASV a safe mode of ventilation for patients with COPD and ARDS? 3) Is ASV a safe mode of ventilation with changes in lung dynamics? 4) Does ASV impact the bedside respiratory therapist? Conclusions: ASV appears to be at least effective or even more superior to other modes especially during weaning off mechanical ventilation, and in other forms of respiratory failure. More studies in different clinical conditions and head-to-head with other modes. Keywords: ASV, COPD, ARDS, Weaning
{"title":"Adaptive Support Ventilation (ASV). Beneficial or not?","authors":"Denise Wheatley, Krystal Young","doi":"10.53097/jmv.10026","DOIUrl":"https://doi.org/10.53097/jmv.10026","url":null,"abstract":"Ventilators functions and features have evolved with the advancement of technology along with the addition of microprocessors. It is important to understand and examine the benefits and risks associated with these advanced automated modes. Adaptive Support Ventilation (ASV) is a mode that is unique to the Hamilton Medical ventilators, thereby limiting the number of clinicians who have experience with using this mode. ASV can make changes to respiratory rate and tidal volume and adjusting the driving pressure in the absence of a professional. ASV changes ventilator strategies when it detects changes to a patient’s lung dynamics. The scope of ASV mode is not universally understood. Respiratory therapists may feel their position would be threatened with the use of smart automated modes. This paper will aim to review the literature on the ASV mode of ventilation. The literature review will address the following research questions to broaden the understanding of the risks and benefits of the ASV mode. 1) Is the ASV mode effective for weaning patients? 2) Is ASV a safe mode of ventilation for patients with COPD and ARDS? 3) Is ASV a safe mode of ventilation with changes in lung dynamics? 4) Does ASV impact the bedside respiratory therapist? Conclusions: ASV appears to be at least effective or even more superior to other modes especially during weaning off mechanical ventilation, and in other forms of respiratory failure. More studies in different clinical conditions and head-to-head with other modes. Keywords: ASV, COPD, ARDS, Weaning","PeriodicalId":73813,"journal":{"name":"Journal of mechanical ventilation","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-02-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48266235","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Patients in the intensive care unit (ICU) especially those who require mechanical ventilation are at increased risk for developing gastrointestinal (GI) complications such as bleeding, infection, and motility dysfunction. It is estimated that the prevalence of GI complications in those patients is approximately 50-80% and lots of those go undiagnosed. Complications can affect different parts of the GI system, including the esophagus, stomach, small intestine, large intestine, liver, and pancreas. Effects might include dysmotility, diarrhea, inflammation, infection, direct mucosal injuries, ulcerations, and bleeding, and it can be associated with high mortality rates. Moreover, it is believed that the GI tract has a significant contribution in the development of multiple organ dysfunction syndrome (MODS) in critically ill patients. Mechanical ventilation either alone or in association with other critical illness may have a multitude of effects on almost all the organs of the gastro-intestinal tract. Attention of those interaction and side effects can improve outcomes and potentially mortality. In this review, we describe the mechanisms proposed for mechanical ventilation induced GI complications and different GI complications which can affect the critically ill patient. Keywords: PEEP, Prone position, Dysmotility, GERD, GI bleeding, Ileus, Aspiration, Acalculous cholecystitis
{"title":"Gastrointestinal complications in critical care patients and effects of mechanical ventilation on the gastrointestinal tract","authors":"Adham E Obeidat, Sandeep Randhawa","doi":"10.53097/jmv.10017","DOIUrl":"https://doi.org/10.53097/jmv.10017","url":null,"abstract":"Patients in the intensive care unit (ICU) especially those who require mechanical ventilation are at increased risk for developing gastrointestinal (GI) complications such as bleeding, infection, and motility dysfunction. It is estimated that the prevalence of GI complications in those patients is approximately 50-80% and lots of those go undiagnosed. Complications can affect different parts of the GI system, including the esophagus, stomach, small intestine, large intestine, liver, and pancreas. Effects might include dysmotility, diarrhea, inflammation, infection, direct mucosal injuries, ulcerations, and bleeding, and it can be associated with high mortality rates. Moreover, it is believed that the GI tract has a significant contribution in the development of multiple organ dysfunction syndrome (MODS) in critically ill patients. Mechanical ventilation either alone or in association with other critical illness may have a multitude of effects on almost all the organs of the gastro-intestinal tract. Attention of those interaction and side effects can improve outcomes and potentially mortality. In this review, we describe the mechanisms proposed for mechanical ventilation induced GI complications and different GI complications which can affect the critically ill patient. Keywords: PEEP, Prone position, Dysmotility, GERD, GI bleeding, Ileus, Aspiration, Acalculous cholecystitis","PeriodicalId":73813,"journal":{"name":"Journal of mechanical ventilation","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-02-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47901057","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Background: Airway pressure release ventilation has been available to clinicians for the last four decades. Unfortunately, its clinical value continues to be debatable. One of the many reasons responsible is the lack of consistency between its settings in clinical practice and research. We hypothesized that clinicians disagree on specific methods when establishing these parameters. Materials and Methods: A questionnaire-based survey was developed and sent to clinicians (critical care attending physician, critical care fellows in training and respiratory therapists) in about one hundred different academic hospitals with critical care training program. The survey consisted of ten questions including each of the four major APRV settings: T-High, T-Low, P-High, and P-Low. The survey was anonymous. Main results: Amongst the 187 respondents, there were significant disagreements between different categories of clinicians regarding methodology for establishing initial settings of APRV. However, when the responses were analyzed after sub-grouping based on categories of clinicians (Critical care attending physician vs critical care fellows vs respiratory therapists), no significant differences could be found. Conclusions: There is no agreement between different categories of clinicians when it comes to the methodology for establishing initial APRV settings. Our study highlights the need for larger clinical trials comparing different approaches to the same which could then be used for establishing scientific guidelines based on best evidence. Keywords: APRV, survey, T-High, T-Low, P-High, P-Low
{"title":"Airway Pressure Release Ventilation setting disagreements. A survey of clinicians","authors":"S. Randhawa, R. Sato, Ehab Daoud","doi":"10.53097/JMV.10010","DOIUrl":"https://doi.org/10.53097/JMV.10010","url":null,"abstract":"Background: Airway pressure release ventilation has been available to clinicians for the last four decades. Unfortunately, its clinical value continues to be debatable. One of the many reasons responsible is the lack of consistency between its settings in clinical practice and research. We hypothesized that clinicians disagree on specific methods when establishing these parameters. Materials and Methods: A questionnaire-based survey was developed and sent to clinicians (critical care attending physician, critical care fellows in training and respiratory therapists) in about one hundred different academic hospitals with critical care training program. The survey consisted of ten questions including each of the four major APRV settings: T-High, T-Low, P-High, and P-Low. The survey was anonymous. Main results: Amongst the 187 respondents, there were significant disagreements between different categories of clinicians regarding methodology for establishing initial settings of APRV. However, when the responses were analyzed after sub-grouping based on categories of clinicians (Critical care attending physician vs critical care fellows vs respiratory therapists), no significant differences could be found. Conclusions: There is no agreement between different categories of clinicians when it comes to the methodology for establishing initial APRV settings. Our study highlights the need for larger clinical trials comparing different approaches to the same which could then be used for establishing scientific guidelines based on best evidence. Keywords: APRV, survey, T-High, T-Low, P-High, P-Low","PeriodicalId":73813,"journal":{"name":"Journal of mechanical ventilation","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2020-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45987611","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
There have been a recent shortage of both critical care physicians and respiratory therapists with training in mechanical ventilation that is accentuated by the recent COVID-19 crisis. Hospitalists and primary care physicians find themselves more often dealing with and treating critically ill patients on mechanical ventilation without specific training. This two part review will try to explain and simplify some of the physiologic concepts of mechanical ventilation, strategies for managements of different diseases, monitoring, brief review of some of the common modes used for support and weaning during mechanical ventilation and to address some of the adverse effects associated with mechanical ventilation. We understand the complexity of the subject and this review would not be a substitute of seeking appropriate counselling, further training, and medical knowledge about mechanical ventilation. Further free resources are available to help clinicians who feel uncomfortable making decisions with such technology Keywords: Mechanical ventilation, Driving pressure, Compliance, Resistance, Capnometry, Dead space, ARDS, PEEP, auto-PEEP, Plateau pressure, esophageal balloon
{"title":"Mechanical ventilation for the non-critical care trained practitioner. Part 1","authors":"Ehab Daoud, Rebecca Shimabukuro Shimabukuro","doi":"10.53097/JMV.10011","DOIUrl":"https://doi.org/10.53097/JMV.10011","url":null,"abstract":"There have been a recent shortage of both critical care physicians and respiratory therapists with training in mechanical ventilation that is accentuated by the recent COVID-19 crisis. Hospitalists and primary care physicians find themselves more often dealing with and treating critically ill patients on mechanical ventilation without specific training. This two part review will try to explain and simplify some of the physiologic concepts of mechanical ventilation, strategies for managements of different diseases, monitoring, brief review of some of the common modes used for support and weaning during mechanical ventilation and to address some of the adverse effects associated with mechanical ventilation. We understand the complexity of the subject and this review would not be a substitute of seeking appropriate counselling, further training, and medical knowledge about mechanical ventilation. Further free resources are available to help clinicians who feel uncomfortable making decisions with such technology Keywords: Mechanical ventilation, Driving pressure, Compliance, Resistance, Capnometry, Dead space, ARDS, PEEP, auto-PEEP, Plateau pressure, esophageal balloon","PeriodicalId":73813,"journal":{"name":"Journal of mechanical ventilation","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2020-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49452203","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Kimiyo H. Yamasaki, J. Mullen, Denise Wheatley, Ron R Sanderson
Objective: Accurate measurements of ventilator length of stay are important for quality measures and mandated by Centers of Disease Control for reporting ventilator associated events. However, it is unknown which method of such a calculation gives the more accurate results. Design: We collected data using three different methods of calculating ventilator length of stay in a community hospital ICU. The first method is the walk-through method for collection of data at 6 am, the second is a data base collection system we created where data was collected by respiratory therapists in a daily ventilator patient log then entered into the database, and finally from query of medical charges for ventilator days from financial department Results: There was statistically significant disagreement between the three methods. The walk though method and data base were not statistically different, but the data from financial charges overestimated the ventilator length of stay. Additionally, there was not statistically significant differences between the time of the walk-through data collection. Conclusion: Ventilator days and hours should be measured by a precise database rather than indirect methods of estimation like walk-through or financial charges. Patient exposure to risk, and reporting of ventilator time, whether days or hours should be measured directly, not estimated. A larger study needs to be performed to examine this variation in a broader medical setting. Keywords: ventilator length of stay, ventilator associated events, ventilator associated pneumonia
{"title":"Accurate measurement of ventilator length of stay and ventilator days for use in assessing patient safety and ventilator associated events.","authors":"Kimiyo H. Yamasaki, J. Mullen, Denise Wheatley, Ron R Sanderson","doi":"10.53097/JMV.10009","DOIUrl":"https://doi.org/10.53097/JMV.10009","url":null,"abstract":"Objective: Accurate measurements of ventilator length of stay are important for quality measures and mandated by Centers of Disease Control for reporting ventilator associated events. However, it is unknown which method of such a calculation gives the more accurate results. Design: We collected data using three different methods of calculating ventilator length of stay in a community hospital ICU. The first method is the walk-through method for collection of data at 6 am, the second is a data base collection system we created where data was collected by respiratory therapists in a daily ventilator patient log then entered into the database, and finally from query of medical charges for ventilator days from financial department Results: There was statistically significant disagreement between the three methods. The walk though method and data base were not statistically different, but the data from financial charges overestimated the ventilator length of stay. Additionally, there was not statistically significant differences between the time of the walk-through data collection. Conclusion: Ventilator days and hours should be measured by a precise database rather than indirect methods of estimation like walk-through or financial charges. Patient exposure to risk, and reporting of ventilator time, whether days or hours should be measured directly, not estimated. A larger study needs to be performed to examine this variation in a broader medical setting. Keywords: ventilator length of stay, ventilator associated events, ventilator associated pneumonia","PeriodicalId":73813,"journal":{"name":"Journal of mechanical ventilation","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2020-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45655122","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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