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Ventilator treatment in the Nordic countries.
A multicenter survey
Author(s) -
Kárason S.,
Antonsen K.,
Åneman A.,
GROUP The SSAI ICUII
Publication year - 2002
Publication title -
acta anaesthesiologica scandinavica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.738
H-Index - 107
eISSN - 1399-6576
pISSN - 0001-5172
DOI - 10.1034/j.1399-6576.2002.460901.x
Subject(s) - medicine , tidal volume , peak inspiratory pressure , intensive care , mean airway pressure , anesthesia , positive end expiratory pressure , airway , mechanical ventilation , respiratory system , intensive care medicine
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 7 ml/kg (6,9), peak inspiratory pressure 22 cmH2O (18,26) and positive end‐expiratory pressure ( PEEP) 6 cmH2O (6,9). FiO 2 was 40% (35,50), SaO 2 97% (95–98), PaO 2 11 kPa (10,13), PaCO 2 5.4 kPa (4.7,6.3), pH 7.43 (7.38,7.47) and BE 2.0 mmol/l (− 0.5,5). The PaO 2 /FiO 2 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 PaO 2 /FiO 2 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.