Publication:
Organizational factors associated with adherence to low tidal volume ventilation: a secondary analysis of the CHECKLIST-ICU database

2

Issued Date

2020-12-01

Resource Type

Article

ISSN

21105820

DOI

10.1186/s13613-020-00687-3

Other identifier(s)

2-s2.0-85085976135

Rights

Mahidol University

Rights Holder(s)

SCOPUS

Bibliographic Citation

Annals of Intensive Care. Vol.10, No.1 (2020)

Suggested Citation

Thais Dias Midega, Fernando A. Bozza, Flávia Ribeiro Machado, Helio Penna Guimarães, Jorge I. Salluh, Antonio Paulo Nassar, Karina Normílio-Silva, Marcus J. Schultz, Alexandre Biasi Cavalcanti, Ary Serpa Neto, Pedro Aniceto Nunes Neto, Carlos Alberto Fernandes, Cristiano Ávila Luchesi, Natalia Rodrigues de Sa, Roberta Antunes Faria Rodrigues, Larissa Stefany Radespiel, Vinicius Leonardo dos Santos Iorio, Danielle Bhering, Viviane Ribeiro Linhares, Glauco Adrieno Westphal, Geonice Sperotto, Soraya Byana Rezende da Silva Rossi, Thaismari Escarmanhani Ferreira, Edgar de Brito Sobrinho, Helder Jose Lima Reis, Mauricio Soares Carneiro, Adriana de Oliveira Lameira Veríssimo, Juliana Fernandez Fernandes, Rodrigo Lopes Ferreira, Sylvania Campos Pinho, Leonardo Dultra, Lise Oliveira Hizumi, Neiva Fernandes de Lima, Alexsandra Raimunda da Silva, Liliane dos Santos, Sidiner Mesquita Vaz, José Marcio Oliveira, Miria Bonjour Laviola, Wania Vasconcelos de Freitas, Leonardo Passos, Ligia Sarmet Cunha Farah Rabello, Carollina Resende de Siqueira, Luiz Carlos de Oliveira Silva, Francisco Felix Barreto Junior, Eduarda Maria Alves Cruz, Luiz Marcelo Sa Malbouisson, Fabiola Prior Caltabeloti, Estevão Bassi, Patrícia Regiane da Silva, Filipe Cadamuro, Renata Graciliano dos Santos Cagnon, Yeh Li Ho, Lucas Chaves Neto, Bruno Azevedo Randi, Michele Maria Goncalves de Godoy, Pollyanna Dutra Sobral, Evônio de Barros Campelo Júnior, Laercio Martins de Stefano, Ana Lucia Gut, Greicy Mara Mengue Feniman de Stefano, Denise Milioli Ferreira, Fernanda Alves Ferreira Gonçalves, Fernanda Rubia Negrao Alves, Wilson Nogueira Filho, Renata Ortiz Marchetti, Sheila Sa, Nadia Tomiko Anabuki, Silvia Regina Rios Vieira, Edino Parolo, Karen Prado, Natalia Gomes Lisboa, Simone Castelo Branco Fortaleza, Maria Liduina Nantua Beserra Porfirio, Marcela Maria Sousa Colares, Rosicley Souza da Silva, Marcia Vasconcelos, Fabio de Souza, Lanese Medeiros de Figueiredo, Niedila Pinheiro Bastos Seabra, Paula Celia Pires de Oliveira, Marcio Andrade Martins, Ricardo Beduschi Muller, Manoela Cristina Recalcatti, Riani Helenditi Fernandes Camurça Martins, Leatrice Emilia Ferreira de França, Frederico Bruzzi de Carvalho, Gustavo Cesar Augusto Moreira, Evelin Drociunas Pacheco Cechinatti, Aline Cristina Passos, Mariana da Costa Ferreira, Antonio Carlos Babo Rodrigues, Vladimir dos Santos Begni, Alfredo Maximo Grilo Jardim, Amanda Carvalho Maciel, Marlus Muri Thompson, Erica Palacio Berçacola Pinheiro, Claudio Henrique Pinto Gonçalves, Ricardo Schilling Rosenfeld, Valéria Abrahao Rosenfeld, Leticia Japiassú Organizational factors associated with adherence to low tidal volume ventilation: a secondary analysis of the CHECKLIST-ICU database. Annals of Intensive Care. Vol.10, No.1 (2020). doi:10.1186/s13613-020-00687-3 Retrieved from: https://repository.li.mahidol.ac.th/handle/123456789/58002

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Title

Organizational factors associated with adherence to low tidal volume ventilation: a secondary analysis of the CHECKLIST-ICU database

Author(s)

Thais Dias Midega
 Fernando A. Bozza
 Flávia Ribeiro Machado
 Helio Penna Guimarães
 Jorge I. Salluh
 Antonio Paulo Nassar
 Karina Normílio-Silva
 Marcus J. Schultz
 Alexandre Biasi Cavalcanti
 Ary Serpa Neto
 Pedro Aniceto Nunes Neto
 Carlos Alberto Fernandes
 Cristiano Ávila Luchesi
 Natalia Rodrigues de Sa
 Roberta Antunes Faria Rodrigues
 Larissa Stefany Radespiel
 Vinicius Leonardo dos Santos Iorio
 Danielle Bhering
 Viviane Ribeiro Linhares
 Glauco Adrieno Westphal
 Geonice Sperotto
 Soraya Byana Rezende da Silva Rossi
 Thaismari Escarmanhani Ferreira
 Edgar de Brito Sobrinho
 Helder Jose Lima Reis
 Mauricio Soares Carneiro
 Adriana de Oliveira Lameira Veríssimo
 Juliana Fernandez Fernandes
 Rodrigo Lopes Ferreira
 Sylvania Campos Pinho
 Leonardo Dultra
 Lise Oliveira Hizumi
 Neiva Fernandes de Lima
 Alexsandra Raimunda da Silva
 Liliane dos Santos
 Sidiner Mesquita Vaz
 José Marcio Oliveira
 Miria Bonjour Laviola
 Wania Vasconcelos de Freitas
 Leonardo Passos
 Ligia Sarmet Cunha Farah Rabello
 Carollina Resende de Siqueira
 Luiz Carlos de Oliveira Silva
 Francisco Felix Barreto Junior
 Eduarda Maria Alves Cruz
 Luiz Marcelo Sa Malbouisson
 Fabiola Prior Caltabeloti
 Estevão Bassi
 Patrícia Regiane da Silva
 Filipe Cadamuro
 Renata Graciliano dos Santos Cagnon
 Yeh Li Ho
 Lucas Chaves Neto
 Bruno Azevedo Randi
 Michele Maria Goncalves de Godoy
 Pollyanna Dutra Sobral
 Evônio de Barros Campelo Júnior
 Laercio Martins de Stefano
 Ana Lucia Gut
 Greicy Mara Mengue Feniman de Stefano
 Denise Milioli Ferreira
 Fernanda Alves Ferreira Gonçalves
 Fernanda Rubia Negrao Alves
 Wilson Nogueira Filho
 Renata Ortiz Marchetti
 Sheila Sa
 Nadia Tomiko Anabuki
 Silvia Regina Rios Vieira
 Edino Parolo
 Karen Prado
 Natalia Gomes Lisboa
 Simone Castelo Branco Fortaleza
 Maria Liduina Nantua Beserra Porfirio
 Marcela Maria Sousa Colares
 Rosicley Souza da Silva
 Marcia Vasconcelos
 Fabio de Souza
 Lanese Medeiros de Figueiredo
 Niedila Pinheiro Bastos Seabra
 Paula Celia Pires de Oliveira
 Marcio Andrade Martins
 Ricardo Beduschi Muller
 Manoela Cristina Recalcatti
 Riani Helenditi Fernandes Camurça Martins
 Leatrice Emilia Ferreira de França
 Frederico Bruzzi de Carvalho
 Gustavo Cesar Augusto Moreira
 Evelin Drociunas Pacheco Cechinatti
 Aline Cristina Passos
 Mariana da Costa Ferreira
 Antonio Carlos Babo Rodrigues
 Vladimir dos Santos Begni
 Alfredo Maximo Grilo Jardim
 Amanda Carvalho Maciel
 Marlus Muri Thompson
 Erica Palacio Berçacola Pinheiro
 Claudio Henrique Pinto Gonçalves
 Ricardo Schilling Rosenfeld
 Valéria Abrahao Rosenfeld
 Leticia Japiassú

Other Contributor(s)

Fundacao Oswaldo Cruz
 A.C.Camargo Cancer Center
 Hospital Israelita Albert Einstein
 Universidade Federal de Sao Paulo
 Mahidol University
 Amsterdam UMC - University of Amsterdam
 Universidade Federal do Rio de Janeiro
 Hospital do Coração (HCor)
 Instituto D’Or de Pesquisa e Ensino (IDOR)

Abstract

© 2020, The Author(s). 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.

Keyword(s)

Medicine

Availability

URI

https://repository.li.mahidol.ac.th/handle/123456789/58002

Collections

Scopus 2020