School of Clinical Medicine (ETDs)

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Invasive mechanical ventilation practices in adult patients in three academic intensive care units
(2024) Coetzee, Gerhard Jacobus
Background Patients with, or at risk of developing, acute respiratory distress syndrome (ARDS) should be identified early, and lung-protective ventilation (LPV) instituted. This study aimed to describe invasive mechanical ventilation practices in adult patients at three academic intensive care units (ICUs) in Johannesburg from November 2021 to January 2022. Methods A point-prevalence, cross-sectional study using consecutive sampling. Results A total of 127 patients were included with a mean age of 40 (±15) years and 66.1% were male. Trauma-related causes (n=51, 40.2%) were the main indications for ventilation. Overall, 107 (84.3%) had risk factors for developing ARDS and 78 (61.4%) had PaO2:FiO2 300, the mean PEEP was 8 cmH2O with a set FiO2 of 0.3. The mean Vt/kg IBW of 5.5 ml/kg IBW in patients who received 6 ml/kg IBW (p=0.0001). Conclusion In this study, a large proportion of patients suffered from acute hypoxaemic respiratory failure, with the vast majority at risk of developing ARDS. Given this profile of patients, compliance with the use of recommended LPV strategies was surprisingly low.