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

dc.creatorMidega, Thais Dias
dc.creatorBozza, Fernando A.
dc.creatorMachado, Flávia Ribeiro
dc.creatorGuimarães, Helio Penna
dc.creatorSalluh, Jorge I.
dc.creatorNassar, Antonio Paulo
dc.creatorNormílio-Silva, Karina
dc.creatorSchultz, Marcus J.
dc.creatorCavalcanti, Alexandre Biasi
dc.creatorSerpa Neto, Ary
dc.date2020-07-24T20:35:01Z
dc.date2020-07-24T20:35:01Z
dc.date2020
dc.date.accessioned2023-09-26T21:12:43Z
dc.date.available2023-09-26T21:12:43Z
dc.identifierMIDEGA, Thais Dias et al. Organizational factors associated with adherence to low tidal volume ventilation: a secondary analysis of the CHECKLIST-ICU database. Annals of Intensive Care, v. 10, n. 1, p. 1-10, 2020.
dc.identifier2110-5820
dc.identifierhttps://www.arca.fiocruz.br/handle/icict/42390
dc.identifier10.1186/s13613-020-00687-3
dc.identifier.urihttps://repositorioslatinoamericanos.uchile.cl/handle/2250/8870897
dc.descriptionBackground: 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.
dc.formatapplication/pdf
dc.languageeng
dc.publisherSpringer
dc.rightsopen access
dc.subjectIntensive care unit
dc.subjectInvasive ventilation
dc.subjectLung protection
dc.subjectOrganizational factors
dc.subjectTidal volume
dc.subjectLow tidal volume ventilation
dc.titleOrganizational factors associated with adherence to low tidal volume ventilation: a secondary analysis of the CHECKLIST-ICU database
dc.typeArticle


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