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Ramírez II, Gutiérrez-Arias R, Damiani LF, Adasme RS, Arellano DH, Salinas FA, Roncalli A, Núñez-Silveira J, Santillán-Zuta M, Sepúlveda-Barisich P, Gordo-Vidal F, Blanch L. Specific Training Improves the Detection and Management of Patient-Ventilator Asynchrony. Respir Care 2024; 69:166-175. [PMID: 38267230 PMCID: PMC10898470 DOI: 10.4187/respcare.11329] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2024]
Abstract
BACKGROUND Patient-ventilator asynchrony is common in patients undergoing mechanical ventilation. The proportion of health-care professionals capable of identifying and effectively managing different types of patient-ventilator asynchronies is limited. A few studies have developed specific training programs, but they mainly focused on improving patient-ventilator asynchrony detection without assessing the ability of health-care professionals to determine the possible causes. METHODS We conducted a 36-h training program focused on patient-ventilator asynchrony detection and management for health-care professionals from 20 hospitals in Latin America and Spain. The training program included 6 h of a live online lesson during which 120 patient-ventilator asynchrony cases were presented. After the 6-h training lesson, health-care professionals were required to complete a 1-h training session per day for the subsequent 30 d. A 30-question assessment tool was developed and used to assess health-care professionals before training, immediately after the 6-h training lecture, and after the 30 d of training (1-month follow-up). RESULTS One hundred sixteen health-care professionals participated in the study. The median (interquartile range) of the total number of correct answers in the pre-training, post-training, and 1-month follow-up were significantly different (12 [8.75-15], 18 [13.75-22], and 18.5 [14-23], respectively). The percentages of correct answers also differed significantly between the time assessments. Study participants significantly improved their performance between pre-training and post-training (P < .001). This performance was maintained after a 1-month follow-up (P = .95) for the questions related to the detection, determination of cause, and management of patient-ventilator asynchrony. CONCLUSIONS A specific 36-h training program significantly improved the ability of health-care professionals to detect patient-ventilator asynchrony, determine the possible causes of patient-ventilator asynchrony, and properly manage different types of patient-ventilator asynchrony.
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Affiliation(s)
- Iván I Ramírez
- Departamento de Apoyo en Rehabilitación Cardiopulmonar Integral, Instituto Nacional del Tórax, Santiago, Chile.
- Faculty of Health Sciences, Diego Portales University, Santiago, Chile
- Division of Critical Care Medicine, Hospital Clinico de la Universidad de Chile, Santiago, Chile
- INTRehab Research Group, Santiago, Chile
| | - Ruvistay Gutiérrez-Arias
- Departamento de Apoyo en Rehabilitación Cardiopulmonar Integral, Instituto Nacional del Tórax, Santiago, Chile
- INTRehab Research Group, Santiago, Chile
- Exercise and Rehabilitation Sciences Institute, Faculty of Rehabilitation Sciences, Universidad Andres Bello, Santiago, Chile
| | - L Felipe Damiani
- Departamento de ciencias de la salud, carrera de Kinesiología (Kinesiology career), Facultad de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Rodrigo S Adasme
- Exercise and Rehabilitation Sciences Institute, Faculty of Rehabilitation Sciences, Universidad Andres Bello, Santiago, Chile
- Division of Pediatric Critical Care Medicine at Hospital Clínico Red de Salud Christus-UC. Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Daniel H Arellano
- Division of Critical Care Medicine, Hospital Clinico de la Universidad de Chile, Santiago, Chile
| | - Francisco A Salinas
- Departamento de Apoyo en Rehabilitación Cardiopulmonar Integral, Instituto Nacional del Tórax, Santiago, Chile
- INTRehab Research Group, Santiago, Chile
- Facultad de Ciencias de la Salud, Universidad Autónoma de Chile, Santiago, Chile
| | | | - Juan Núñez-Silveira
- Division of Critical Care Medicine, Hospital Italiano, Buenos Aires, Argentina
| | - Milton Santillán-Zuta
- Critical Care Department, Hospital Nacional Guillermo Almenara, Lima, Perú
- Faculty of Health Science at Universidad Nacional Toribio Rodríguez de Mendoza, Amazonas, Perú
| | | | - Federico Gordo-Vidal
- Intensive Care Department, Hospital Universitario del Henares, Coslada, Madrid, Spain
- Grupo de investigación en patología crítica, Facultad de Medicina, Universidad Francisco de Vitoria, Pozuelo de Alarcón, Madrid, Spain
- Centro de Investigacion Biomedica en Red de Enfermedades Respiratorias, Instituto de Salud Carlos III, Madrid, Spain
| | - Lluís Blanch
- Critical Care Center, Parc Taulí Hospital Universitari, Institut d'Investigacio i Innovacio Parc Taulí I3PT-CERCA, Universitat Autonoma de Barcelona, Sabadell, Spain
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