Organizational factors associated with adherence to low tidal volume ventilation: a secondary analysis of the CHECKLIST-ICU database
| Autor(a) principal: | |
|---|---|
| Data de Publicação: | 2020 |
| Outros Autores: | , , , , , , , , |
| Tipo de documento: | Artigo |
| Idioma: | eng |
| Título da fonte: | Repositório Institucional da FIOCRUZ (ARCA) |
| Texto Completo: | https://www.arca.fiocruz.br/handle/icict/42390 |
Resumo: | Hospital Israelita Albert Einstein. Department of Critical Care Medicine. São Paulo, SP, Brazil. |
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Midega, Thais DiasBozza, Fernando A.Machado, Flávia RibeiroGuimarães, Helio PennaSalluh, Jorge I.Nassar, Antonio PauloNormílio-Silva, KarinaSchultz, Marcus J.Cavalcanti, Alexandre BiasiSerpa Neto, Ary2020-07-24T20:35:01Z2020-07-24T20:35:01Z2020MIDEGA, Thais Dias et al. Organizational factors associated with adherence to low tidal volume ventilation: a secondary analysis of the CHECKLIST-ICU database. Annals of Intensive Care, v. 10, n. 1, p. 1-10, 2020.2110-5820https://www.arca.fiocruz.br/handle/icict/4239010.1186/s13613-020-00687-3engSpringerOrganizational factors associated with adherence to low tidal volume ventilation: a secondary analysis of the CHECKLIST-ICU databaseinfo:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/articleHospital Israelita Albert Einstein. Department of Critical Care Medicine. São Paulo, SP, Brazil.Fundação Oswaldo Cruz. Instituto Nacional de Infectologia Evandro Chagas. Rio de Janeiro, RJ, Brasil / Instituto D’Or de Pesquisa e Ensino. Research Institute. Rio de Janeiro, RJ, Brazil.Federal University of São Paulo. Anesthesiology, Pain and Intensive Care Department. São Paulo, SP, Brazil.Hospital Israelita Albert Einstein. Department of Critical Care Medicine. São Paulo, SP, Brazil / Hospital Israelita Albert Einstein. Academic Research Organization. São Paulo, SP, Brazil.Instituto D’Or de Pesquisa e Ensino. Graduate Program in Translational Medicine and Department of Critical Care. Rio de Janeiro, RJ, Brazil / Universidade Federal do Rio de Janeiro. Post Graduate Program in Internal Medicine. Rio de Janeiro, RJ, Brazil.Background: Survival benefit from low tidal volume (VT) ventilation (LTVV) has been demonstrated for patients with acute respiratory distress syndrome (ARDS), and patients not having ARDS could also benefit from this strategy. Organizational factors may play a role on adherence to LTVV. The present study aimed to identify organizational factors with an independent association with adherence to LTVV. Methods: Secondary analysis of the database of a multicenter two-phase study (prospective cohort followed by a cluster-randomized trial) performed in 118 Brazilian intensive care units. Patients under mechanical ventilation at day 2 were included. LTVV was defined as a VT ≤ 8 ml/kg PBW on the second day of ventilation. Data on the type and number of beds of the hospital, teaching status, nursing, respiratory therapists and physician staffing, use of structured checklist, and presence of protocols were tested. A multivariable mixed-effect model was used to assess the association between organizational factors and adherence to LTVV. Results: The study included 5719 patients; 3340 (58%) patients received LTVV. A greater number of hospital beds (absolute difference 7.43% [95% confidence interval 0.61-14.24%]; p = 0.038), use of structured checklist during multidisciplinary rounds (5.10% [0.55-9.81%]; p = 0.030), and presence of at least one nurse per 10 patients during all shifts (17.24% [0.85-33.60%]; p = 0.045) were the only three factors that had an independent association with adherence to LTVV. Conclusions: Number of hospital beds, use of a structured checklist during multidisciplinary rounds, and nurse staffing are organizational factors associated with adherence to LTVV. These findings shed light on organizational factors that may improve ventilation in critically ill patients.Intensive care unitInvasive ventilationLung protectionOrganizational factorsTidal volumeLow tidal volume ventilationinfo:eu-repo/semantics/openAccessreponame:Repositório Institucional da FIOCRUZ (ARCA)instname:Fundação Oswaldo Cruz (FIOCRUZ)instacron:FIOCRUZLICENSElicense.txtlicense.txttext/plain; charset=utf-83099https://www.arca.fiocruz.br/bitstream/icict/42390/1/license.txt586c046dcfeef936e32f0323bb9a47c0MD51ORIGINALOrganizational_Fernando_Bozza_etal_INI_2020.pdfOrganizational_Fernando_Bozza_etal_INI_2020.pdfapplication/pdf1326381https://www.arca.fiocruz.br/bitstream/icict/42390/2/Organizational_Fernando_Bozza_etal_INI_2020.pdfdaf5ec4bc00d761e0ca11ac3ac387e9aMD52TEXTOrganizational_Fernando_Bozza_etal_INI_2020.pdf.txtOrganizational_Fernando_Bozza_etal_INI_2020.pdf.txtExtracted 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| dc.title.pt_BR.fl_str_mv |
Organizational factors associated with adherence to low tidal volume ventilation: a secondary analysis of the CHECKLIST-ICU database |
| title |
Organizational factors associated with adherence to low tidal volume ventilation: a secondary analysis of the CHECKLIST-ICU database |
| spellingShingle |
Organizational factors associated with adherence to low tidal volume ventilation: a secondary analysis of the CHECKLIST-ICU database Midega, Thais Dias Intensive care unit Invasive ventilation Lung protection Organizational factors Tidal volume Low tidal volume ventilation |
| title_short |
Organizational factors associated with adherence to low tidal volume ventilation: a secondary analysis of the CHECKLIST-ICU database |
| title_full |
Organizational factors associated with adherence to low tidal volume ventilation: a secondary analysis of the CHECKLIST-ICU database |
| title_fullStr |
Organizational factors associated with adherence to low tidal volume ventilation: a secondary analysis of the CHECKLIST-ICU database |
| title_full_unstemmed |
Organizational factors associated with adherence to low tidal volume ventilation: a secondary analysis of the CHECKLIST-ICU database |
| title_sort |
Organizational factors associated with adherence to low tidal volume ventilation: a secondary analysis of the CHECKLIST-ICU database |
| author |
Midega, Thais Dias |
| author_facet |
Midega, Thais Dias Bozza, Fernando A. Machado, Flávia Ribeiro Guimarães, Helio Penna Salluh, Jorge I. Nassar, Antonio Paulo Normílio-Silva, Karina Schultz, Marcus J. Cavalcanti, Alexandre Biasi Serpa Neto, Ary |
| author_role |
author |
| author2 |
Bozza, Fernando A. Machado, Flávia Ribeiro Guimarães, Helio Penna Salluh, Jorge I. Nassar, Antonio Paulo Normílio-Silva, Karina Schultz, Marcus J. Cavalcanti, Alexandre Biasi Serpa Neto, Ary |
| author2_role |
author author author author author author author author author |
| dc.contributor.author.fl_str_mv |
Midega, Thais Dias Bozza, Fernando A. Machado, Flávia Ribeiro Guimarães, Helio Penna Salluh, Jorge I. Nassar, Antonio Paulo Normílio-Silva, Karina Schultz, Marcus J. Cavalcanti, Alexandre Biasi Serpa Neto, Ary |
| dc.subject.en.pt_BR.fl_str_mv |
Intensive care unit Invasive ventilation Lung protection Organizational factors Tidal volume Low tidal volume ventilation |
| topic |
Intensive care unit Invasive ventilation Lung protection Organizational factors Tidal volume Low tidal volume ventilation |
| description |
Hospital Israelita Albert Einstein. Department of Critical Care Medicine. São Paulo, SP, Brazil. |
| publishDate |
2020 |
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2020-07-24T20:35:01Z |
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2020-07-24T20:35:01Z |
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2020 |
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info:eu-repo/semantics/publishedVersion |
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info:eu-repo/semantics/article |
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article |
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MIDEGA, Thais Dias et al. Organizational factors associated with adherence to low tidal volume ventilation: a secondary analysis of the CHECKLIST-ICU database. Annals of Intensive Care, v. 10, n. 1, p. 1-10, 2020. |
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https://www.arca.fiocruz.br/handle/icict/42390 |
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2110-5820 |
| dc.identifier.doi.none.fl_str_mv |
10.1186/s13613-020-00687-3 |
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MIDEGA, Thais Dias et al. Organizational factors associated with adherence to low tidal volume ventilation: a secondary analysis of the CHECKLIST-ICU database. Annals of Intensive Care, v. 10, n. 1, p. 1-10, 2020. 2110-5820 10.1186/s13613-020-00687-3 |
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eng |
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Springer |
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Springer |
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