Higher Class of Obesity Is Associated With Delivery of Higher Tidal Volumes in Subjects With ARDS.
BACKGROUND: Little is known to what extent attitudes of ICU clinicians are influenced by new insights and recommendations to be more conservative with oxygen therapy. Our aim was to investigate whether implementation of a conservative oxygenation guideline structurally changed self-reported attitude...
| Publicado en: | Respiratory Care Vol. 65; no. 10; pp. 1519 - 1527 |
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| Autores principales: | , , , , , , |
| Formato: | research tables/charts Journal Article |
| Publicado: |
Mary Ann Liebert, Inc.
Oct2020
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| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=146059460&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 146059460 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 00201324 4GG jtl: Respiratory Care issn: 00201324 maglogo: N pubinfo: dt: Oct2020 vid: 65 iid: 10 pid: 1365 pub: Mary Ann Liebert, Inc. place: New Rochelle, New York artinfo: ui: 146059460 146059460 146059460 10.4187/respcare.07527 146059460 ppf: 1519 ppct: 8 formats: fmt: @attributes: type: P tig: atl: Higher Class of Obesity Is Associated With Delivery of Higher Tidal Volumes in Subjects With ARDS. aug: au: Grim, Chloe C. A. Helmerhorst, Hendrik JF Schultz, Marcus J. Winters, Tineke van der Voort, Peter H. J. van Westerloo, David J. de Jonge, Evert affil: Department of Intensive Care Medicine, Leiden University Medical Center, Leiden, The Netherlands sug: subj: Obesity, Morbid Respiration, Artificial Methods Respiratory Distress Syndrome, Acute Therapy Tidal Volume Physiology Body Mass Index Respiratory Distress Syndrome, Acute Human Prospective Studies Retrospective Design Nonexperimental Studies Length of Stay Airway Pressure Comparative Studies Body Weight Multivariate Analysis Odds Ratio Confidence Intervals Mortality Descriptive Statistics ab: BACKGROUND: Little is known to what extent attitudes of ICU clinicians are influenced by new insights and recommendations to be more conservative with oxygen therapy. Our aim was to investigate whether implementation of a conservative oxygenation guideline structurally changed self-reported attitudes and actual clinical practice. METHODS: After the implementation of a conservative oxygen therapy guideline in 3 teaching hospitals in the Netherlands, ICU clinicians were surveyed regarding their attitudes toward oxygen therapy. The survey results were compared with survey results taken before the introduction of the new guideline. Arterial blood gas analysis data and ventilator settings were retrieved from all patients admitted to the participating ICUs in the studied period, and changes after implementing the guideline were assessed. RESULTS: In total, 180 ICU clinicians returned the survey. Compared to before implementation of a conservative oxygen guideline, more clinicians chose a preferred PaO2 and an oxygen saturation measured from an arterial sample (SaO2) limit after implementation of the guideline. In general, clinicians reported a more conservative approach toward management of FIO2 and less frequently increased the FIO2. In the period after the active implementation of the guideline, 5,840 subjects were admitted to the participating ICUs and 101,869 arterial blood gas analyses were retrieved. Actual practice changed with overall lower oxygenation levels (median PaO2 77.93 mm Hg, compared to 86.93 mm Hg before implementation) of arterial blood and a decrease of PEEP and FIO2. CONCLUSIONS: Implementing a conservative oxygenation guideline was an effective method that changed self-reported attitudes and actual clinical practice and improved adherence to conservative oxygenation targets in a short period of time. pubtype: Academic Journal doctype: research tables/charts Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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