Publication:
Survey of respiratory support for intensive care patients in 10 tertiary hospital of Thailand

2

Issued Date

2014-01-01

Resource Type

Article

ISSN

01252208

Other identifier(s)

2-s2.0-84902335887

Rights

Mahidol University

Rights Holder(s)

SCOPUS

Bibliographic Citation

Journal of the Medical Association of Thailand. Vol.97, No.1 SUPPL. 1 (2014)

Suggested Citation

Kaweesak Chittawatanarat, Kanwan Jaikriengkrai, Chairat Permpikul, Chairat Permpikul, Onuma Chaiwat, Suneerat Kongsayreepong, Puttipunnee Vorrakitpokatorn, Warakarn Wilaichone, Thananchai Bunburaphong, Wanwimol Saengchote, Sunthiti Morakul, Thammasak Thawitsri, Chanchai Sitthipan, Wanna Sombunvibul, Phornlert Chatrkaw, Sahadol Poonyathawon, Anan Watanathum, Pusit Fuengfoo, Dusit Sataworn, Adisorn Wongsa, Kunchit Piyavechviratana, Suthat Rungruanghiranya, Chaichan Pothirat, Attawut Deesomchok, Boonsong Patjanasoontorn, Rungsun Bhurayanontachai, Ratapum Champunut, Norawee Chuachamsai, Chaweewan Thongchai Survey of respiratory support for intensive care patients in 10 tertiary hospital of Thailand. Journal of the Medical Association of Thailand. Vol.97, No.1 SUPPL. 1 (2014). Retrieved from: https://repository.li.mahidol.ac.th/handle/123456789/34856

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Title

Survey of respiratory support for intensive care patients in 10 tertiary hospital of Thailand

Author(s)

Kaweesak Chittawatanarat
 Kanwan Jaikriengkrai
 Chairat Permpikul
 Chairat Permpikul
 Onuma Chaiwat
 Suneerat Kongsayreepong
 Puttipunnee Vorrakitpokatorn
 Warakarn Wilaichone
 Thananchai Bunburaphong
 Wanwimol Saengchote
 Sunthiti Morakul
 Thammasak Thawitsri
 Chanchai Sitthipan
 Wanna Sombunvibul
 Phornlert Chatrkaw
 Sahadol Poonyathawon
 Anan Watanathum
 Pusit Fuengfoo
 Dusit Sataworn
 Adisorn Wongsa
 Kunchit Piyavechviratana
 Suthat Rungruanghiranya
 Chaichan Pothirat
 Attawut Deesomchok
 Boonsong Patjanasoontorn
 Rungsun Bhurayanontachai
 Ratapum Champunut
 Norawee Chuachamsai
 Chaweewan Thongchai

Other Contributor(s)

Chiang Mai University
 Mahidol University
 Faculty of Medicine, Siriraj Hospital, Mahidol University
 Faculty of Medicine, Ramathibodi Hospital, Mahidol University
 King Chulalongkorn Memorial Hospital, Faculty of Medicine Chulalongkorn University
 Phramongkutklao College of Medicine
 MRH Maha Chakri Sirindhorn Medical Center
 Maharaj Nakorn Chiang Mai Hospital
 Srinagarind hospital
 Prince of Songkha Hospital
 Buddhachinaraj Phitsanulok Hospital
 Prapokklao Hospital

Abstract

Objective: There are varieties of clinical practices for intensive care respiratory support. However, there has been no published report characterizing its current practice in Thailand. The present study was undertaken to characterize the practice of respiratory support for intensive care patients in Thai tertiary hospitals. Material and Method: A cross-sectional survey and retrospective historical cohort of intensive care units (ICUs) was performed on May 30, 2011 from ten tertiary hospitals in Thailand. The participating ICUs were asked to complete the following data of all patients who were mechanically ventilated in the ICUs: Demographic data, characteristics of respiratory support, ICU type, causes of respiratory failure, and weaning technique. Results: A total of 258 patients from ten tertiary hospitals were included and analyzed. The medical ICU patients remained in the ICU significantly longer than patients in other ICUs. Patients in surgical ICUs were significantly younger than patients in other ICUs. The prevalence of mechanically ventilated patients in this survey was 64.7% with a significantly higher proportion in the medical ICUs. The median of ventilator days was also significantly higher in the medical ICUs. An invasive ventilator was more commonly used in all ICUs rather than non-invasive ventilators. The three common causes of respiratory support were severe sepsis or septic shock, respiratory failure and post-operation, respectively. Volume-controlled continuous mandatory ventilation (VC-CMV) ventilation was more commonly used as the initial mode of ventilation in both surgical and medical ICUs. The maximum plateau pressure was significantly higher in the medical ICU patients but there were no differences in maximum tidal volume and PEEP level. One-third of the patients were in the weaning process, mostly in the medical ICUs. Pressure support was the predominant weaning mode in the medical ICUs, while synchronized intermittent mandatory ventilation (SIMV) was more predominant in the surgical ICUs. Protocol-based weaning was used in approximately two-thirds of patients who were in the weaning process. With repeated estimation equation logistic model and left censors' cohort to 28 days, the medical ICUs had significantly lower ventilator free overtime individual patients when compared with surgical ICUs, while there was no difference within mixed ICUs. Conclusion: The VC-CMV was more commonly used as the initial mode of ventilation in both surgical and medical ICUs. Pressure support was the predominant weaning mode in the medical ICUs, while SIMV was more predominant in the surgical ICUs. Individual patients in medical ICU had a greater number of ventilator days and less probability of being ventilatorfree.

Keyword(s)

Medicine

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URI

https://repository.li.mahidol.ac.th/handle/123456789/34856

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Scopus 2011-2015