METHODS: Staff training with emphasis on the applied DP in mechanical ventilation was provided during one year. After completion of staff training, the effect was prospectively evaluated in patients who were continuously mechanically ventilated in a controlled mode for at least 6 h starting from admission. Pressure difference (Pdiff = Ppeak - PEEPtot) in the baseline period, as a derivative of the driving pressure, was compared with two evaluation periods from 0 to 6 months and 6-12 months (i.e. follow-up) after completion of the training.
RESULTS: At analysis 248 patients met the inclusion criteria. In the baseline period Pdiff was not lung protective (> 15 cm H2O) in 39% of cases. In the first follow-up period this decreased to 25% of cases and further dropped to 17% in the second follow-up period. This was a relative decrease of 56% compared to the training period. At the end of evaluation the proportion of patients with a safe Pdiff had gradually increased from 58% during training to 82% (χ2 = p 0.005).
CONCLUSIONS: These results suggest that ICU staff training could lead to more adequate respiratory support provided during controlled mechanical ventilation.
方法:在一年的时间里,对机械通气中应用DP的员工进行了培训。员工培训完成后,前瞻性评估了从入院开始以受控模式持续机械通气至少6小时的患者的效果.基线期间的压差(Pdiff=Ppeak-PEEPtot),作为驱动压力的导数,与完成训练后0至6个月和6-12个月(即随访)的两个评估期进行比较。
结果:在分析中,248例患者符合纳入标准。在基线期,在39%的病例中,Pdiff不是肺保护性的(>15cmH2O)。在第一个随访期间,这一比例下降到25%,在第二个随访期间进一步下降到17%。与训练期相比,这相对减少了56%。在评估结束时,具有安全Pdiff的患者比例从训练期间的58%逐渐增加到82%(χ2=p0.005)。
结论:这些结果表明,ICU工作人员的培训可以在控制机械通气期间提供更充分的呼吸支持。