A multi-center survey of medical staffs′ cognition and management of prolonged mechanical ventilation in pediatric intensive care unit
10.3760/cma.j.issn.1673-4912.2022.05.006
- VernacularTitle:儿童重症监护病房医护人员对长期机械通气认知及管理现况的多中心调查
- Author:
Pan LIU
1
;
Zhengzheng ZHANG
;
Yi ZHANG
;
Hengmiao GAO
;
Hong REN
;
Dong QU
;
Wei XU
;
Chengjun LIU
;
Hongjun MIAO
;
Li HUANG
;
Zihao YANG
;
Furong ZHANG
;
Yibing CHENG
;
Guoping LU
;
Weiming CHEN
Author Information
1. 复旦大学附属儿科医院PICU，上海 201102
- Keywords:
Prolonged mechanical ventilation;
Pediatric intensive care unit;
Survey;
Awareness
- From:
Chinese Pediatric Emergency Medicine
2022;29(5):347-352
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To investigate the status of cognition and clinical management of prolonged mechanical ventilation(PMV) among medical staffs in pediatric intensive care unit(PICU) in China, and in order to improve the awareness of PICU medical staffs on PMV and standardize the management of PMV.Methods:The cross-sectional study was conducted with doctors and nurses in PICUs of the collaborative group as the survey objects from July 12 to September 12, 2020.The questionnaire was issued, collected and checked by the Children′s Hospital of Fudan University.Results:(1) PMV related settings: Nine out of eleven hospitals had established PMV multidisciplinary teams, respiratory techniques such as diaphragm ultrasound and airway peak flow monitoring could be respectively executed in 72.7% and 36.4% of PICU.Pulmonary rehabilitation techniques such as airway clearance techniques, induced spirometer exercise, external diaphragm pacemaker stimulation, transfer bed exercise, balloon blowing, hyperbaric oxygen therapy could be respectively executed in 100.0%, 9.1%, 9.1%, 9.1%, 27.3% and 27.3% of PICU, respectively.(2) The cognitive status quo of children′s PMV: The most medical staffs agreed with the view that PMV referred to the children′s continuous mechanical ventilation for more than two weeks.Sixty percent of medical staffs believed that children with PMV had basic central nervous system diseases, and 62.7% of medical staffs believed that the most common causes of difficulty in PMV weaning was abnormal brain function.(3) The cognitive status quo of the children′s PMV management in PICU: Respondents believed that the most commonly used mechanical ventilation mode was synchronized intermittent mandatory ventilation+ pressure support ventilation in children′s PMV during stable disease.Ninety-two percent of medical staffs performed the spontaneous breathing test when weaning.And 58.7% of the respondents agreed to perform tracheotomy for the children during 3 to 4 weeks of mechanical ventilation.More than half of medical staffs would execute diaphragm function assessment, bedside rehabilitation training, nutritional assessment, analgesia and sedation assessment for children with PMV.(4) The cognitive status quo of the children′s PMV management of transition from hospital to family: 54.5% of PICU provided family care training to the family members before the children were discharged from the hospital.One center established the PMV specialized outpatient clinic.45.5% of PICU would follow up these discharged children one month later.Conclusion:At present, PICU medical staffs have different awareness of children′s PMV related problems in China.And children′s PMV lacks a systematic plan regarding diagnosis, treatment and management.
