Pediatric Respiratory Support Technology and Practices: A Global Survey †
Abstract
:1. Introduction
2. Materials and Methods
3. Results
3.1. Respiratory Support Capabilities
3.2. Respiratory System Component Availability
3.3. Factors that Promote the Ongoing Use of New Equipment and Technology for Survey Respondents
3.4. Assessment and Charting of Respiratory Distress or Failure
4. Discussion
5. Conclusions
Supplementary Materials
Acknowledgments
Author Contributions
Conflicts of Interest
References
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Characteristics of Respondents and Their Facilities | LMIC n (%) | HIC n (%) | |
---|---|---|---|
Number of participants n = 357 | Survey started | 118 | 239 |
Survey completed | 100 | 205 | |
Survey attrition rate | 18 | 34 | |
Geographic Representation n = 357 | Number of countries represented | 36 | 28 |
Occupation n = 357 | Nurse | 7 | 59 |
Respiratory Therapist | 4 | 13 | |
Physician | 105 | 163 | |
Other | 2 | 4 | |
Facility setting n = 354 | Urban | 101 | 209 |
Suburban | 8 | 21 | |
Rural | 5 | 7 | |
Other | 2 | 1 | |
Facility type n = 354 | Public | 88 | 198 |
Private | 23 | 36 | |
Faith-based | 3 | 1 | |
Other | 2 | 3 | |
Facility level of care n = 353 | Primary | 5 | 2 |
Secondary | 10 | 10 | |
Tertiary | 96 | 223 | |
Other | 2 | 5 | |
Bed types n = 352 | Neonatal ICU | 86 | 170 |
Pediatric ICU | 74 | 196 | |
Mixed pediatric/adult ICU | 17 | 30 | |
Adult ICU | 32 | 56 | |
Mean number of patients managed by one health care provider at time n = 327 | Physicians | ||
Emergency Room | 22 | 19 | |
PICU | 19 | 10 | |
NICU | 26 | 13 | |
Nurses | |||
Emergency Room | 9 | 9 | |
NICU | 5 | 2 | |
PICU | 6 | 3 | |
Tracking hospital acquired infections n = 310 | Yes | 94 | 192 |
No | 7 | 9 | |
Don't know | 2 | 6 |
Characteristics of Respiratory Support Available | LMIC n (%) | HIC n (%) | |
---|---|---|---|
Management of acute pediatric respiratory failure n = 339 | Maximize supplemental oxygen | 76 | 180 |
Bag-mask ventilation | 68 | 136 | |
High flow nasal cannula support | 79 | 182 | |
Noninvasive positive pressure support | 98 | 208 | |
Intubation and manual ventilation | 50 | 110 | |
Intubation and mechanical ventilation | 105 | 214 | |
Transport to a higher level of care | 21 | 34 | |
ECMO | 38 | 102 | |
Non-invasive respiratory support used n = 339 | Bilevel Positive Airway Pressure (BiPAP) | 75 | 177 |
Bubble CPAP | 43 | 81 | |
Continuous Positive Airway Pressure (CPAP) | 95 | 199 | |
High flow nasal cannula (HFNC) | 76 | 173 | |
Oxygen via facemask or nasal cannula | 87 | 195 | |
Noninvasive positive pressure respiratory support or HFNC not available | 16 | 34 | |
Other | 9 | 5 | |
Availability and regular use of respiratory system components n = 322 | Oxygen source | 106 | 216 |
Air source | 104 | 206 | |
Air and Oxygen | 104 | 206 | |
Gas blender | 92 | 178 | |
Gas humidifier or heater | 101 | 196 | |
Breathing circuit or tubing | 104 | 198 | |
Patient interface | 106 | 201 | |
Positive pressure ventilation system (e.g., CPAP, BiPAP, HFNC, ventilator) | 105 | 200 | |
Oxygen saturation monitor | 106 | 202 | |
Oxygen source n = 322 | Wall outlet | 104 | 211 |
Bottles | 51 | 120 | |
Oxygen concentrator | 13 | 21 | |
Other | 2 | 0 | |
Don't know | 31 | 0 | |
Air source n = 322 | Wall outlet | 101 | 198 |
Bottles | 29 | 74 | |
Oxygen concentrator | 18 | 18 | |
Other | 0 | 0 | |
Electric pump | 1 | 4 | |
Don’t know | 1 | 2 | |
Humidifiers used n = 322 | Bubble or bottle humidifier | 56 | 122 |
Pass over or wick humidifier | 28 | 78 | |
Heat and moisture exchanger (HME) | 55 | 143 | |
Other | 2 | 2 | |
Don’t know | 31 | 28 |
Factors rated “Very Important” in Ongoing Use of New Equipment (n = 310) | LMIC n (%) | HIC n (%) |
---|---|---|
Equipment safety | 66 | 154 |
Adequate training and support of doctors and nurses | 67 | 138 |
Scientific (published) clinical evidence | 62 | 132 |
Personal experience | 38 | 94 |
Durability of the equipment | 38 | 69 |
User-friendliness of the equipment | 32 | 65 |
Ongoing technical and maintenance support | 30 | 61 |
Initial equipment cost | 29 | 55 |
Workload of medical staff | 25 | 54 |
Reusability of all equipment components | 26 | 39 |
Ongoing costs (electricity, consumables, maintenance) | 23 | 35 |
Use is required by a supervisor or manager | 11 | 23 |
Respiratory Assessment Method Used (n = 307) | LMIC n (%) | HIC n (%) |
---|---|---|
Oxygen saturation | 98 | 202 |
Work of breathing (grunting, flaring, tracheal tugging) | 97 | 202 |
Chest retractions (degree, location) | 96 | 199 |
Respiratory rate | 95 | 198 |
Blood gas | 97 | 193 |
Heart rate | 93 | 193 |
General clinical impression | 94 | 186 |
FiO2 | 88 | 187 |
Cyanosis | 87 | 179 |
Mental status | 82 | 181 |
Other | 10 | 13 |
© 2017 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/).
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Arnim, A.O.v.S.A.-v.; Jamal, S.M.; John-Stewart, G.C.; Musa, N.L.; Roberts, J.; Stanberry, L.I.; Howard, C.R.A. Pediatric Respiratory Support Technology and Practices: A Global Survey. Healthcare 2017, 5, 34. https://doi.org/10.3390/healthcare5030034
Arnim AOvSA-v, Jamal SM, John-Stewart GC, Musa NL, Roberts J, Stanberry LI, Howard CRA. Pediatric Respiratory Support Technology and Practices: A Global Survey. Healthcare. 2017; 5(3):34. https://doi.org/10.3390/healthcare5030034
Chicago/Turabian StyleArnim, Amélie O. von Saint André-von, Shelina M. Jamal, Grace C. John-Stewart, Ndidiamaka L. Musa, Joan Roberts, Larissa I. Stanberry, and Christopher R. A. Howard. 2017. "Pediatric Respiratory Support Technology and Practices: A Global Survey" Healthcare 5, no. 3: 34. https://doi.org/10.3390/healthcare5030034