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Airway care interventions for invasively ventilated critically ill adults: A Dutch national survey

Abstract:
Airway care interventions may prevent accumulation of airway secretions and promote their evacuation, but evidence is scarce. Interventions include heated humidification, nebulization of mucolytics and/or bronchodilators, manual hyperinflation and use of mechanical insufflation-exsufflation (MI-E). Our aim is to identify current airway care practices for invasively ventilated patients in intensive care units (ICU) in the Netherlands. A self–administered web-based survey was sent to a single pre–appointed representative of all ICUs in the Netherlands. Response rate was 85% (72 ICUs). We found substantial heterogeneity in the intensity and combinations of airway care interventions used. Most (81%) ICUs reported using heated humidification as a routine prophylactic intervention. All (100%) responding ICUs used nebulized mucolytics and/or bronchodilators; however, only 43% ICUs reported nebulization as a routine prophylactic intervention. Most (81%) ICUs used manual hyperinflation, although only initiated with a clinical indication like difficult oxygenation. Few (22%) ICUs used MI-E for invasively ventilated patients. Use was always based on the indication of insufficient cough strength or as a continuation of home use. In the Netherlands, use of routine prophylactic airway care interventions is common despite evidence of no benefit. There is an urgent need for evidence of the benefit of these interventions to inform evidence-based guidelines.
Publication status:
Published
Peer review status:
Peer reviewed

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Publisher copy:
10.3390/jcm10153381

Authors


More by this author
Institution:
University of Oxford
Division:
MSD
Department:
NDM
Role:
Author
ORCID:
0000-0003-3969-7792
More by this author
Role:
Author
ORCID:
0000-0003-1700-3972


Publisher:
MDPI
Journal:
Journal of Clinical Medicine More from this journal
Volume:
10
Issue:
15
Article number:
3381
Publication date:
2021-07-30
Acceptance date:
2021-07-17
DOI:
EISSN:
2077-0383
Pmid:
34362165


Language:
English
Keywords:
Pubs id:
1190520
Local pid:
pubs:1190520
Deposit date:
2022-01-11

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