دورية أكاديمية
Poor Adherence to Lung-Protective Mechanical Ventilation in Pediatric Acute Respiratory Distress Syndrome.
| العنوان: | Poor Adherence to Lung-Protective Mechanical Ventilation in Pediatric Acute Respiratory Distress Syndrome. |
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| المؤلفون: | Ward, Shan L, Quinn, Carson M, Valentine, Stacey L, Sapru, Anil, Curley, Martha AQ, Willson, Douglas F, Liu, Kathleen D, Matthay, Michael A, Flori, Heidi R |
| المصدر: | Pediatric critical care medicine : a journal of the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies, vol 17, iss 10 |
| بيانات النشر: | eScholarship, University of California |
| سنة النشر: | 2016 |
| المجموعة: | University of California: eScholarship |
| مصطلحات موضوعية: | Humans, Respiration, Artificial, Critical Care, Adolescent, Child, Preschool, Infant, Newborn, Intensive Care Units, Pediatric, Guideline Adherence, Female, Male, Practice Guidelines as Topic, Practice Patterns, Physicians', Respiratory Distress Syndrome, Rare Diseases, Lung, Nutrition, Acute Respiratory Distress Syndrome, Clinical Research, Obesity, Patient Safety, Respiratory, acute lung injury, ideal body weight, mechanical ventilation, pediatric acute respiratory distress syndrome |
| جغرافية الموضوع: | 917 - 923 |
| الوصف: | ObjectivesTo determine the frequency of low-tidal volume ventilation in pediatric acute respiratory distress syndrome and assess if any demographic or clinical factors improve low-tidal volume ventilation adherence.DesignDescriptive post hoc analysis of four multicenter pediatric acute respiratory distress syndrome studies.SettingTwenty-six academic PICU.PatientsThree hundred fifteen pediatric acute respiratory distress syndrome patients.Measurements and main resultsAll patients who received conventional mechanical ventilation at hours 0 and 24 of pediatric acute respiratory distress syndrome who had data to calculate ideal body weight were included. Two cutoff points for low-tidal volume ventilation were assessed: less than or equal to 6.5 mL/kg of ideal body weight and less than or equal to 8 mL/kg of ideal body weight. Of 555 patients, we excluded 240 for other respiratory support modes or missing data. The remaining 315 patients had a median PaO2-to-FIO2 ratio of 140 (interquartile range, 90-201), and there were no differences in demographics between those who did and did not receive low-tidal volume ventilation. With tidal volume cutoff of less than or equal to 6.5 mL/kg of ideal body weight, the adherence rate was 32% at hour 0 and 33% at hour 24. A low-tidal volume ventilation cutoff of tidal volume less than or equal to 8 mL/kg of ideal body weight resulted in an adherence rate of 58% at hour 0 and 60% at hour 24. Low-tidal volume ventilation use was no different by severity of pediatric acute respiratory distress syndrome nor did adherence improve over time. At hour 0, overweight children were less likely to receive low-tidal volume ventilation less than or equal to 6.5 mL/kg ideal body weight (11% overweight vs 38% nonoverweight; p = 0.02); no difference was noted by hour 24. Furthermore, in the overweight group, using admission weight instead of ideal body weight resulted in misclassification of up to 14% of patients as receiving low-tidal volume ventilation when they actually were ... |
| نوع الوثيقة: | article in journal/newspaper |
| وصف الملف: | application/pdf |
| اللغة: | unknown |
| العلاقة: | qt14f1g1kd; https://escholarship.org/uc/item/14f1g1kdTest; https://escholarship.org/content/qt14f1g1kd/qt14f1g1kd.pdfTest |
| DOI: | 10.1097/pcc.0000000000000903 |
| الإتاحة: | https://doi.org/10.1097/pcc.0000000000000903Test https://escholarship.org/uc/item/14f1g1kdTest https://escholarship.org/content/qt14f1g1kd/qt14f1g1kd.pdfTest |
| حقوق: | public |
| رقم الانضمام: | edsbas.3ADF9E00 |
| قاعدة البيانات: | BASE |
| DOI: | 10.1097/pcc.0000000000000903 |
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