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Modes of mechanical ventilation vary between hospitals and intensive care units within a university healthcare system: a retrospective observational study
Journal article   Open access   Peer reviewed

Modes of mechanical ventilation vary between hospitals and intensive care units within a university healthcare system: a retrospective observational study

Craig S Jabaley, Robert F Groff, Milad Sharifpour, Jayashree K Raikhelkar and James M Blum
BMC research notes, Vol.11(1), pp.425-425
07/03/2018
DOI: 10.1186/s13104-018-3534-z
PMCID: PMC6029057
PMID: 29970159
url
https://doi.org/10.1186/s13104-018-3534-zView
Published (Version of record) Open Access

Abstract

Objective: As evidence-based guidance to aid clinicians with mechanical ventilation mode selection is scant, we sought to characterize the epidemiology thereof within a university healthcare system and hypothesized that nonconforming approaches could be readily identified. We conducted an exploratory retrospective observational database study of routinely recorded mechanical ventilation parameters between January 1, 2010 and December 31, 2016 from 12 intensive care units. Mode epoch count proportions were examined using Chi squared and Fisher exact tests as appropriate on an inter-unit basis with outlier detection for two test cases via post hoc pairwise analyses of a binomial regression model. Results: Final analysis included 559,734 mode epoch values. Significant heterogeneity was demonstrated between individual units (P < 0.05 for all comparisons). One unit demonstrated heightened utilization of high-frequency oscillatory ventilation, and three units demonstrated frequent synchronized intermittent mandatory ventilation utilization. Assist control ventilation was the most commonly recorded mode (51%), followed by adaptive support ventilation (23.1%). Volume-controlled modes were about twice as common as pressure-controlled modes (64.4% versus 35.6%). Our methodology provides a means by which to characterize the epidemiology of mechanical ventilation approaches and identify nonconforming practices. The observed variability warrants further clinical study about contributors and the impact on relevant outcomes.
 Intensive Care Positive pressure ventilation Respiratory failure Mechanical ventilators Research Note Noninvasive ventilation Ventilator weaning

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