TY - JOUR
T1 - Ventilator treatment in the Nordic countries. A multicenter survey
AU - Kárason, Sigurbergur
AU - Antonsen, K.
AU - Åneman, A.
AU - Möller, Alma
AU - Åvall, Anders
AU - Samuelsson, Anders
AU - Blöndal, Ásbjörn
AU - Valsson, Felix
AU - Shemais, Heba
AU - Christensen, Henrik
AU - Bergmann, Jón Bragi
AU - Claesson, Jonas
AU - Laurilla, Jouko
AU - Larsen, Kim M.
AU - Sigvaldason, Kristinn
AU - Knudsen, Kurt
AU - Quist, Lars
AU - Skielboe, Martin
AU - Rolfseng, Ole Kristian
AU - Rossi, Patrik
AU - Stjernholm, Peter
AU - Sarbonovski, Roman
AU - Hovilehto, Seppo
AU - Walther, Sten
AU - Varpula, Tero
PY - 2002
Y1 - 2002
N2 - Background: A 1-day point prevalence study was performed in the Nordic countries to identify ventilator-treatment strategies in the region. Material and methods: On 30 May 30 2001 all mechanically ventilated patients in 27 intensive care units (ICUs) were registered via the internet. The results are shown as medians (25th, 75th percentile). Results: One hundred and eight patients were included (69% male) with new simplified acute physiology score (SAPS) 48 (37, 57) and 4.5 d (2, 11) of ventilator treatment. The most frequent indication for ventilator treatment was acute respiratory failure (73%). Airway management was by endotracheal tube (64%), tracheostomy (32%) and facial mask (4%). Pressure regulated ventilator modes were used in 86% of the patients and spontaneous triggering was allowed in 75%. The tidal volume was 7ml/kg (6, 9), peak inspiratory pressure 22cmH2O (18, 26) and positive end-expiratory pressure (PEEP) 6cmH2O (6, 9). FiO2 was 40% (35, 50), SaO2 97% (95-98), PaO2 11 kPa (10, 13), PaCO2 5.4 kPa (4.7, 6.3), pH7.43 (7.38, 7.47) and BE 2.0mmol/1 (-0.5, 5). The PaO2/FiO2 ratio was 220 mmHg (166, 283). The peak inspiratory pressure (r=0.37), mean airway pressure (r=0.36), PEEP (r=0.33), tidal volume (r=0.22) and SAPS score (r=0.19) were identified as independent variables in relation to the PaO2/FiO2 ratio. Conclusion: The vast majority of patients were ventilated with pressure-regulated modes. Tidal volume was well below what has been considered conventional in recent large trials. Correlations between the parameters of gas exchange, respiratory mechanics, ventilator settings and physiological status of the patients was poor. It appears that blood gas values are the main tool used to steer ventilator treatment. These results may help to design future interventional studies of ventilator treatment.
AB - Background: A 1-day point prevalence study was performed in the Nordic countries to identify ventilator-treatment strategies in the region. Material and methods: On 30 May 30 2001 all mechanically ventilated patients in 27 intensive care units (ICUs) were registered via the internet. The results are shown as medians (25th, 75th percentile). Results: One hundred and eight patients were included (69% male) with new simplified acute physiology score (SAPS) 48 (37, 57) and 4.5 d (2, 11) of ventilator treatment. The most frequent indication for ventilator treatment was acute respiratory failure (73%). Airway management was by endotracheal tube (64%), tracheostomy (32%) and facial mask (4%). Pressure regulated ventilator modes were used in 86% of the patients and spontaneous triggering was allowed in 75%. The tidal volume was 7ml/kg (6, 9), peak inspiratory pressure 22cmH2O (18, 26) and positive end-expiratory pressure (PEEP) 6cmH2O (6, 9). FiO2 was 40% (35, 50), SaO2 97% (95-98), PaO2 11 kPa (10, 13), PaCO2 5.4 kPa (4.7, 6.3), pH7.43 (7.38, 7.47) and BE 2.0mmol/1 (-0.5, 5). The PaO2/FiO2 ratio was 220 mmHg (166, 283). The peak inspiratory pressure (r=0.37), mean airway pressure (r=0.36), PEEP (r=0.33), tidal volume (r=0.22) and SAPS score (r=0.19) were identified as independent variables in relation to the PaO2/FiO2 ratio. Conclusion: The vast majority of patients were ventilated with pressure-regulated modes. Tidal volume was well below what has been considered conventional in recent large trials. Correlations between the parameters of gas exchange, respiratory mechanics, ventilator settings and physiological status of the patients was poor. It appears that blood gas values are the main tool used to steer ventilator treatment. These results may help to design future interventional studies of ventilator treatment.
KW - Intensive care unit
KW - Mechanical ventilation
KW - Recruitment maneuvers
KW - Respiratory failure
KW - Tidal volume
KW - Ventilator settings
UR - http://www.scopus.com/inward/record.url?scp=18544379635&partnerID=8YFLogxK
U2 - 10.1034/j.1399-6576.2002.460901.x
DO - 10.1034/j.1399-6576.2002.460901.x
M3 - Review article
C2 - 12366498
AN - SCOPUS:18544379635
SN - 0001-5172
VL - 46
SP - 1053
EP - 1061
JO - Acta Anaesthesiologica Scandinavica
JF - Acta Anaesthesiologica Scandinavica
IS - 9
ER -