Department of Pediatrics, Warren Alpert Medical School, Women and Infants Hospital, Brown University, Providence, Rhode Island.
Am J Perinatol. 2019 Apr;36(5):484-489. doi: 10.1055/s-0038-1669442. Epub 2018 Sep 6.
To provide current data on ventilation practices and use of volume-targeted ventilation (VTV) in neonatal intensive care units of the United States and Canada, to identify the perceived barriers to the implementation of VTV, and to assess the knowledge base of appropriate initial tidal volume ( ) settings for different hypothetical clinical scenarios.
This was a cross-sectional online survey of individual neonatologists practicing in the United States and Canada.
We received 387 responses (estimated response rate: ∼20%). Use of VTV was much higher in Canada (81%) compared with 39% in the United States. In the United States, VTV use is highest in the Northwest at 77% and lowest in the Northeast at 32.5%. The chief barrier to use of VTV was lack of knowledge about VTV and lack of appropriate equipment. The five clinical scenarios revealed that the majority of responders failed to select appropriate evidence-based for the specific scenario.
Pressure-controlled ventilation remains the predominant approach to neonatal ventilation in the United States, while VTV is the preferred mode in Canada. Despite available data and important pathophysiological differences between patients, there is insufficient understanding of how to choose an appropriate in a variety of common clinical scenarios among users of VTV.
提供美国和加拿大新生儿重症监护病房通气实践和容量目标通气（VTV）使用的最新数据，确定实施 VTV 的感知障碍，并评估针对不同假设临床情况的适当初始潮气量（ ）设置的知识库。
这是一项针对在美国和加拿大执业的个体新生儿科医生的横断面在线调查。
我们收到了 387 份回复（估计回复率：约 20%）。加拿大的 VTV 使用量（81%）明显高于美国（39%）。在美国，VTV 的使用量在西北地区最高，为 77%，在东北地区最低，为 32.5%。使用 VTV 的主要障碍是缺乏对 VTV 的了解和缺乏适当的设备。五个临床情况表明，大多数应答者未能为特定情况选择适当的基于证据的 。
压力控制通气仍然是美国新生儿通气的主要方法，而 VTV 是加拿大的首选模式。尽管有可用的数据和患者之间重要的病理生理学差异，但 VTV 用户对如何在各种常见临床情况下选择适当的 了解不足。
