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Survey of Ventilation Practices in the Neonatal Intensive Care Units of the United States and Canada: Use of Volume-Targeted Ventilation and Barriers to Its Use
- Source :
- American journal of perinatology. 36(5)
- Publication Year :
- 2018
-
Abstract
- Objective To provide current data on ventilation practices and use of volume-targeted ventilation (VTV) in neonatal intensive care units of the United States and Canada, to identify the perceived barriers to the implementation of VTV, and to assess the knowledge base of appropriate initial tidal volume (VT ) settings for different hypothetical clinical scenarios. Study Design This was a cross-sectional online survey of individual neonatologists practicing in the United States and Canada. Results We received 387 responses (estimated response rate: ∼20%). Use of VTV was much higher in Canada (81%) compared with 39% in the United States. In the United States, VTV use is highest in the Northwest at 77% and lowest in the Northeast at 32.5%. The chief barrier to use of VTV was lack of knowledge about VTV and lack of appropriate equipment. The five clinical scenarios revealed that the majority of responders failed to select appropriate evidence-based VT for the specific scenario. Conclusion Pressure-controlled ventilation remains the predominant approach to neonatal ventilation in the United States, while VTV is the preferred mode in Canada. Despite available data and important pathophysiological differences between patients, there is insufficient understanding of how to choose an appropriate VT in a variety of common clinical scenarios among users of VTV.
- Subjects :
- medicine.medical_specialty
Canada
Cross-sectional study
Infant, Newborn, Diseases
law.invention
03 medical and health sciences
0302 clinical medicine
law
Intensive care
Intensive Care Units, Neonatal
medicine
Humans
Lack of knowledge
Practice Patterns, Physicians'
Response rate (survey)
030219 obstetrics & reproductive medicine
Practice patterns
business.industry
Neonatal ventilation
Infant, Newborn
Obstetrics and Gynecology
Volume targeted ventilation
Respiration, Artificial
United States
Cross-Sectional Studies
Health Care Surveys
Pediatrics, Perinatology and Child Health
Ventilation (architecture)
Emergency medicine
business
Subjects
Details
- ISSN :
- 10988785
- Volume :
- 36
- Issue :
- 5
- Database :
- OpenAIRE
- Journal :
- American journal of perinatology
- Accession number :
- edsair.doi.dedup.....00f89ccc0ce3ee91345607b09de68dc0