The Complexities of Mechanical Ventilation: Toppling the Tower of Babel.

Respir Care

Enterprise Respiratory Care Research, Cleveland Clinic, Cleveland, Ohio; and Department of Medicine, Lerner College of Medicine of Case Western Reserve University, Cleveland, Ohio.

Published: June 2023

The exponential increase in the complexity of ventilator technology has created a growing knowledge gap that hinders education, research, and ultimately the quality of patient care. This gap is best addressed with a standardized approach to educating clinicians, just as education for basic and advanced life support classes is standardized. We have developed such a program, called Standardized Education for Ventilatory Assistance (SEVA), based on a formal taxonomy for modes of mechanical ventilation. The SEVA program is a progressive system of 6 sequential courses starting from an assumption of no prior knowledge and proceeding to full mastery of advanced techniques. The vision of the program is to provide a unique platform for standardizing training by unifying the concepts of physics, physiology, and technology of mechanical ventilation. The mission is to use both online and in-person simulation-based instruction that has both self-directed and instructor-led components to elevate the skills of health care providers to the mastery level. The first 3 levels of SEVA are free and open to the public. We are developing mechanisms to offer the other levels. Spinoffs of the SEVA program include a free smartphone app that classifies virtually all modes on all ventilators used in the United States (Ventilator Mode Map), a free biweekly online training sessions focusing on waveform interpretation (SEVA-VentRounds), and modifications to the electronic health care record system for entering and charting ventilator orders.

Download full-text PDF

Source
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC10208993PMC
http://dx.doi.org/10.4187/respcare.10828DOI Listing

Publication Analysis

Top Keywords

mechanical ventilation
12
seva program
8
health care
8
complexities mechanical
4
ventilation toppling
4
toppling tower
4
tower babel
4
babel exponential
4
exponential increase
4
increase complexity
4

Similar Publications

Background: Although more risk prediction models are available for feeding intolerance in enteral-nourishment patients, it is still unclear how well these models will work in clinical settings. Future research faces challenges in validating model accuracy across populations, enhancing interpretability for clinical use, and overcoming dataset limitations.

Objective: To thoroughly examine studies that have been published on feeding intolerance risk prediction models for enteral nutrition patients.

View Article and Find Full Text PDF

Background: Although substantial evidence exists regarding the treatment of pressure ulcers, there is a lack of studies demonstrating a comprehensive nursing approach for managing pressure ulcers in the ICU, particularly among patients with invasive mechanical ventilation from developing countries like Honduras. This gap in research is significant as the risk and impact of pressure ulcers on health recovery cannot be disregarded.

Objective: This study aimed to analyze Honduran nursing care for pressure ulcers in patients with invasive mechanical ventilation admitted to Intensive Care Units.

View Article and Find Full Text PDF

The use of non-invasive ventilation (NIV) in patients with advanced cystic fibrosis (CF) has increased in recent years. Research evidence supports its clinical benefits, but less is known about the patients' experience of its long-term use in a domiciliary setting. To investigate patients' lived experience of using long-term domiciliary NIV.

View Article and Find Full Text PDF

Objective: The authors sought to evaluate the role of nutritional indices such as Onodera's prognostic nutrition index (PNI), World Health Organization (WHO)-based anthropometric measurements such as weight for age (w/a), height for age, weight for height, and perioperative serum albumin levels in the determination of postoperative clinical outcomes in pediatric patients who undergo surgery for congenital cardiac defects and surgical complexity (risk-adjusted congenital heart surgery score) and its correlation with postoperative course.

Material And Methods: In this prospective observational study, 108 post-pediatric cardiac surgery patients under the age of 18 months were enrolled between January 2023 and August 2023. Through receiver operating characteristic curve analysis we have found the cutoff value for PNI is ≤66.

View Article and Find Full Text PDF

Introduction: A main feature of CDH is lung hypoplasia and the related presentation of pulmonary hypertension and cardiac dysfunction. Multiple factors influence pulmonary status after CDH: degree of hypoplasia, ventilator-induced injury, altered growth and development of pulmonary structures, reduced diaphragm function and chest wall abnormalities. The evolution of pulmonary sequela in this population is still unclear.

View Article and Find Full Text PDF

Want AI Summaries of new PubMed Abstracts delivered to your In-box?

Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!