Amsterdam University of Applied Sciences
Current Practice of Airway Care in ICUs in the Netherlands
Stilma, W.; van der Hoeven, S.M.; Scholte op Reimer, W.J.M.; Schultz, M.J.; Rose, L.;
Paulus, F.
Publication date 2019
Document Version Final published version
Link to publication
Citation for published version (APA):
Stilma, W., van der Hoeven, S. M., Scholte op Reimer, W. J. M., Schultz, M. J., Rose, L., &
Paulus, F. (2019). Current Practice of Airway Care in ICUs in the Netherlands. Poster session presented at 29th ERS (European Respiratory Society) International Congress 2019: Madrid, Madrid , Spain. https://ers-eposter.key4events.com/145/69452.pdf
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Download date:26 Nov 2021
Current Practice of Airway Care in ICUs in the Netherlands
W. Stilma, S.M. van der Hoeven, W.J.M. Scholte op Reimer, M.J. Schultz, L. Rose, F. Paulus.
Introduction
Nebulization therapy (NEB), heated humidification (HH), mechanical in-exsufflation (MI-E) and manual hyperinflation (MH) are strategies against airway plugging in invasively ventilated ICU patients.
There is a lack of evidence for benefit of any of these interventions, and consequently guidelines are variable in promoting their use.
Contact: w.stilma@amsterdamumc.nl
Aims and hypothesis
To describe current practice of airway plugging prevention in ICUs in the Netherlands.
The hypothesis was that NEB, HH, MI-E and MH are variable used in ICUs in the Netherlands.
Results
Response rate was 72/85 ICUs (87%). Baseline characteristics are presented in Table 1. Reported use of HH, NEB, MH and MI-E are listed in Table 2.
Frequencies of use of airway care interventions per ICU are visualized in Figure 1.
Conclusion
Nebulization therapy, heated humidification, MI-E and manual hyperinflation are variably used in Dutch
ICUs. There is urgent need for studies focusing on the efficacy of these interventions to guide practice in
ventilated ICU patients.
Methods
Self-reported web-based survey sent to all 85 ICUs that serve adult critically ill patients in the Netherlands.
The survey was tested for face validity and time to complete. For each ICU, one professional with expertise in airway care was identified and invited.
Table 1. Baseline characteristics respondents Dutch ICUs (N=72)
Characteristics n (%)
Respondent
IC-Nurse 31 (43)
IC-Nurse with additional ventilation course 35 (49)
Physician (intensivist) 6 (8)
Type of Hospital
Academic 6 (8)
Teaching 32 (44)
General 34 (47)
ICU beds capable of mechanical ventilation
3-5 10 (14)
6-10 16 (22)
11-20 20 (28)
21-30 21 (29)
>30 5 (7)
Figure 1. Airway care interventions used in Dutch ICUs (N=72)
smaller ICUS larger ICUs
NEB HH MI-E MH
Darker colors represent a higher frequency of use.
Each vertical bar represents one ICU.
<30 21-30 11-20 6-10 3-5
Table 2: Reported use of airway care interventions by respondents Dutch ICUs (N=72)
Characteristics n (%, 95% CI)
Nebulization therapy
Routinely in every invasively ventilated patient 31 (43%, 31 to 55)
Only on special indication 41 (57%, 48 to 69)
Heated humidification
Routinely in every invasively ventilated patient 20 (28%, 18 to 40)
Only on special indication 49 (68%, 56 to 79)
Never used 3 (4%, 0.9 to 12)
Mechanical In- Exsufflation
Only on special indication in ICU patients 16 (22%, 13 to 34)
Never used 56 (78%, 66 to 87)
Manual Hyperinflation
Routinely in every invasively ventilated patient 5 (7%, 2 to 15)
Only on special indication 53 (74%, 62 to 83)
Never used 16 (19%, 11 to 30)
