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A Novel Rescue Technique for Difficult Intubation and Difficult Ventilation
Published on: January 17, 2011
[RUSSIAN NATIONAL EPIDEMIOLOGICAL STUDY "RUVENT": THE USE OF ARTIFICIAL LUNG VENTILATION IN THE INTENSIVE THERAPY IN
Insights
The RuVent study found that mechanical ventilation practices in Russian pediatric ICUs align with international standards, though significant differences exist in prolonged cases compared to adults. Key reasons for ventilation include respiratory system pathologies and sepsis.
Area of Science:
- Pediatric Critical Care Medicine
- Respiratory Physiology
- Epidemiology
Context:
- Prolonged mechanical ventilation is critical for critically ill children.
- Understanding current practices in pediatric intensive care units (ICUs) is essential for improving patient outcomes.
- The
- RuVent
- study addresses a gap in knowledge regarding pediatric mechanical ventilation in Russia.
Purpose:
- To investigate the real-world application of various modes and parameters for prolonged respiratory support in Russian pediatric ICUs.
- To compare pediatric mechanical ventilation practices in Russia with international standards.
Summary:
- The
- RuVent
- study analyzed data from 104 children across 29 ICUs in Russia and Ukraine, focusing on mechanical ventilation use.
- Respiratory system pathologies, such as acute respiratory distress syndrome and pneumonia, were primary indications for ventilation.
- Managed modes (SIMV, A/C, BIPAP) were preferred, with limited use of non-invasive support (1%).
- The incidence of ventilator-associated pneumonia was 27.9%, and overall lethality was 20.7%.
Impact:
- Provides crucial epidemiological data on pediatric mechanical ventilation in Russia.
- Highlights potential areas for practice improvement and targeted interventions.
- Informs clinical decision-making and resource allocation in pediatric critical care.
Unlabelled:
Purpose of this part of the "RuVent" research is to study the real use of the various modes and parameters of prolonged respiratory support in children in Russia.
Materials And Methods:
The study included 104 children from 29 ICUs (28 in Russian Federation, 1 in Ukraine) under the age of 15 years with ALV duration more than 12 hours in the period from February 7 to 11, 2011. The collection of information performed through online forms.
Results:
Total lethality was 20.7% (18 of 87 patients). The main reasons for prolonged respiratory support in children were the pathology of the respiratory system: acute respiratory distress syndrome (21.2%), community-acquired pneumonia (9.5%), sepsis (8.2%), and congenital disorders of the central nervous system (8.2%) and cardiac arrest (8.2%). According to the study "RuVent" doctors mostly prefer managed modes of respiratory support (SIMV 41.3%, A/C 28.8%, BIPAP 12.5%). Frequency of non-invasive respiratory support use amounted to 1%. Real respiratory volume based on ideal body weight calculation, averaged for boys 9.2 (7.3; 11.2) ml/kg (n = 54), for girls--8.7 (7.1; 10.1) m/kg (n = 38). PEEP median amounted to 4 mbar Tracheostomy was performed in 12 children out of 104 (11.5%), predominantly classic (n = 11), puncture dilated tracheostomy was performed in 1 child. The median of the tracheostomy installation in children was 24.5 days. The duration of respiratory support in children was 11 days (5; 25) (n = 43). The incidence of ventilator-associated pneumonia in children was 27.9% (12 of 43 cases).
Conclusions:
The results of the Russian national epidemiological study of the use of mechanical ventilation in the Intensive care unit ("RuVent") showed comparable data with real international clinical practice. The researchers noted significant differences during prolonged mechanical ventilation in children compared with adult patients.
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