The utilization of aerosol therapy in mechanical ventilation patients: a prospective multicenter observational cohort study and a review of the current evidence
机构：[1]Department of Critical Care Medicine, Peking University People’s Hospital, Beijing, China[2]Department of Cardiopulmonary Sciences, Division of Respiratory Care, Rush University Medical Center, Chicago, IL, USA[3]Department of Respiratory Care, Zhejiang University School of Medical Sir Run Run Shaw Hospital, Hangzhou, China[4]Department of Neurosurgical, Tongji Medical College of Huazhong University of Science and Technology Tongji Hospital, Wuhan, China华中科技大学同济医学院附属同济医院[5]Department of Critical Care Medicine, Dazhou Central Hospital, Dazhou, China[6]Intensive Care Unit, the First People’s Hospital of Yunnan Province, Kunming, China外科片重症医学科云南省第一人民医院[7]Department of Respiratory and Critical Care Medicine, Binzhou Medical University Hospital, Binzhou, China[8]Department of Critical Care Medicine, Peking University International Hospital, Beijing, China[9]Department of Critical Care Medicine, Yongchuan Hospital of Chongqing Medical University, Chongqing, China[10]Department of Surgical Intensive Care Unit, the First Affiliated Hospital of Xi’an Jiaotong University, Xi’an, China[11]Department of Critical Care Medicine, the Third People's Hospital of Mianyang, Mianyang, China[12]Department of Respiratory and Critical Care Medicine, the First Affiliated Hospital of Chongqing Medical University, Chongqing, China重庆医科大学附属第一医院[13]Aerogen Pharma Corp, San Mateo, CA, USA[14]Department of Respiratory and Critical Care Medicine, Peking University People’s Hospital, Beijing, China[15]Department of Respiratory and Critical Care Medicine, West China Medical Center, Sichuan University, Chengdu, China
Background: Aerosol delivery via mechanical ventilation has been reported to vary significantly among different intensive care units (ICU). The optimal technique for using each aerosol generator may need to be updated with the available evidence. Methods: A 2-week prospective multicenter observational cohort study was implemented to record aerosol delivery for mechanically ventilated adult patients in Chinese ICUs. Our data included the type of aerosol device and its placement, ventilator type, humidification, and aerosolized medication administered. A guide for the optimal technique for aerosol delivery during mechanical ventilation was summarized after a thorough literature review. Results: A total of 160 patients (105 males) from 28 ICUs were enrolled, of whom 125 (78.1%) received aerosol therapy via invasive ventilation. Among these 125 patients, 53 received ventilator-integrated jet nebulizer, with 64% (34/53) of them placed the nebulizer close to Y piece in the inspiratory limb. Further, 56 patients used continuous nebulizers, with 84% (47/56) of them placed the nebulizer close to the Y piece in the inspiratory limb. Of the 35 patients who received aerosol therapy via noninvasive ventilation, 30 received single limb ventilators and continuous nebulizers, with 70% (21/30) of them placed between the mask and exhalation port. Only 36% (58/160) of the patients received aerosol treatments consistent with optimal practice. Conclusions: Aerosol delivery via mechanical ventilation varied between ICUs, and only 36% of the patients received aerosol treatments consistent with optimal practice. ICU clinicians should be educated on the best practices for aerosol therapy, and quality improvement projects aim to improve the quality and outcome of patients with the optimal technique for aerosol delivery during mechanical ventilation are warranted.
基金：
National Science and Technology Major Project for Control and Prevention of Major Infectious Diseases of China [2017ZX10103004]
第一作者机构：[1]Department of Critical Care Medicine, Peking University People’s Hospital, Beijing, China
共同第一作者：
通讯作者：
通讯机构：[14]Department of Respiratory and Critical Care Medicine, Peking University People’s Hospital, Beijing, China[15]Department of Respiratory and Critical Care Medicine, West China Medical Center, Sichuan University, Chengdu, China[*1]Department of Respiratory and Critical Care Medicine, West China Medical Center, Sichuan University, 37 Guo Xue Street, Chengdu, China[*2]Department of Respiratory and Critical Care Medicine, Peking University People’s Hospital, No. 11 Xizhimen Nandajie Beijing, China
推荐引用方式(GB/T 7714)：
Shan Lyu,Jie Li,Limin Yang,et al.The utilization of aerosol therapy in mechanical ventilation patients: a prospective multicenter observational cohort study and a review of the current evidence[J].ANNALS OF TRANSLATIONAL MEDICINE.2020,8(17):doi:10.21037/atm-20-1313.
APA：
Shan Lyu,Jie Li,Limin Yang,Xiaoliang Du,Xiaoyi Liu...&Respiratory Care Committee in Chinese Thoracic Society.(2020).The utilization of aerosol therapy in mechanical ventilation patients: a prospective multicenter observational cohort study and a review of the current evidence.ANNALS OF TRANSLATIONAL MEDICINE,8,(17)
MLA：
Shan Lyu,et al."The utilization of aerosol therapy in mechanical ventilation patients: a prospective multicenter observational cohort study and a review of the current evidence".ANNALS OF TRANSLATIONAL MEDICINE 8..17(2020)
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