Skip to main content
Top
Published in: Intensive Care Medicine 3/2014

01-03-2014 | Editorial

Should mechanical ventilation care be centralized and should we thus transfer all ventilated patients to high volume units? Take a breath first

Authors: Marcus J. Schultz, Peter E. Spronk

Published in: Intensive Care Medicine | Issue 3/2014

Login to get access

Excerpt

For years, many critical care physicians considered mechanical ventilation as an easy and harmless intervention in intensive care unit (ICU) patients. Nowadays, preclinical and clinical researchers and critical care physicians increasingly appreciate the potential harmful effects of ventilation, in both patients with the acute respiratory distress syndrome (ARDS) [1] and those with uninjured lungs [2]. Ventilation turns out to be everything but safe, as it can cause so-called ‘ventilator-induced lung injury’ (VILI) [3] and ‘ventilator-induced diaphragm dysfunction’ (VIDD) [4]. Mitigating this harm is far from simple. It requires skill, which like all skills improves with experience. …
Literature
1.
go back to reference Putensen C, Theuerkauf N, Zinserling J, Wrigge H, Pelosi P (2009) Meta-analysis: ventilation strategies and outcomes of the acute respiratory distress syndrome and acute lung injury. Ann Int Med 151:566–576PubMedCrossRef Putensen C, Theuerkauf N, Zinserling J, Wrigge H, Pelosi P (2009) Meta-analysis: ventilation strategies and outcomes of the acute respiratory distress syndrome and acute lung injury. Ann Int Med 151:566–576PubMedCrossRef
2.
go back to reference Serpa Neto A, Cardoso SO, Manetta JA, Pereira VG, Esposito DC, Pasqualucci Mde O, Damasceno MC, Schultz MJ (2012) Association between use of lung-protective ventilation with lower tidal volumes and clinical outcomes among patients without acute respiratory distress syndrome: a meta-analysis. JAMA 308:1651–1659PubMedCrossRef Serpa Neto A, Cardoso SO, Manetta JA, Pereira VG, Esposito DC, Pasqualucci Mde O, Damasceno MC, Schultz MJ (2012) Association between use of lung-protective ventilation with lower tidal volumes and clinical outcomes among patients without acute respiratory distress syndrome: a meta-analysis. JAMA 308:1651–1659PubMedCrossRef
3.
4.
go back to reference Levine S, Nguyen T, Taylor N, Friscia ME, Budak MT, Rothenberg P, Zhu J, Sachdeva R, Sonnad S, Kaiser LR, Rubinstein NA, Powers SK, Shrager JB (2008) Rapid disuse atrophy of diaphragm fibers in mechanically ventilated humans. New Engl J Med 358:1327–1335PubMedCrossRef Levine S, Nguyen T, Taylor N, Friscia ME, Budak MT, Rothenberg P, Zhu J, Sachdeva R, Sonnad S, Kaiser LR, Rubinstein NA, Powers SK, Shrager JB (2008) Rapid disuse atrophy of diaphragm fibers in mechanically ventilated humans. New Engl J Med 358:1327–1335PubMedCrossRef
5.
go back to reference Kanhere MH, Kanhere HA, Cameron A, Maddern GJ (2012) Does patient volume affect clinical outcomes in adult intensive care units? Intensive Care Med 38:741–751PubMedCrossRef Kanhere MH, Kanhere HA, Cameron A, Maddern GJ (2012) Does patient volume affect clinical outcomes in adult intensive care units? Intensive Care Med 38:741–751PubMedCrossRef
6.
go back to reference Kahn JM, Goss CH, Heagerty PJ, Kramer AA, O’Brien CR, Rubenfeld GD (2006) Hospital volume and the outcomes of mechanical ventilation. New Engl J Med 355:41–50PubMedCrossRef Kahn JM, Goss CH, Heagerty PJ, Kramer AA, O’Brien CR, Rubenfeld GD (2006) Hospital volume and the outcomes of mechanical ventilation. New Engl J Med 355:41–50PubMedCrossRef
7.
go back to reference Halm EA, Lee C, Chassin MR (2002) Is volume related to outcome in health care? A systematic review and methodologic critique of the literature. Ann Int Med 137:511–520PubMedCrossRef Halm EA, Lee C, Chassin MR (2002) Is volume related to outcome in health care? A systematic review and methodologic critique of the literature. Ann Int Med 137:511–520PubMedCrossRef
8.
go back to reference Gopal S, O’Brien R, Pooni J (2011) The relationship between hospital volume and mortality following mechanical ventilation in the intensive care unit. Minerva Anestesiol 77:26–32PubMed Gopal S, O’Brien R, Pooni J (2011) The relationship between hospital volume and mortality following mechanical ventilation in the intensive care unit. Minerva Anestesiol 77:26–32PubMed
9.
go back to reference Needham DM, Bronskill SE, Rothwell DM, Sibbald WJ, Pronovost PJ, Laupacis A, Stukel TA (2006) Hospital volume and mortality for mechanical ventilation of medical and surgical patients: a population-based analysis using administrative data. Crit Care Med 34:2349–2354PubMedCrossRef Needham DM, Bronskill SE, Rothwell DM, Sibbald WJ, Pronovost PJ, Laupacis A, Stukel TA (2006) Hospital volume and mortality for mechanical ventilation of medical and surgical patients: a population-based analysis using administrative data. Crit Care Med 34:2349–2354PubMedCrossRef
10.
go back to reference Moran JL, Solomon PJ, Outcome ACf, Resource evaluation of the A, New Zealand Intensive Care S (2012) Mortality and intensive care volume in ventilated patients from 1995 to 2009 in the Australian and New Zealand binational adult patient intensive care database*. Crit Care Med 40:800–812CrossRef Moran JL, Solomon PJ, Outcome ACf, Resource evaluation of the A, New Zealand Intensive Care S (2012) Mortality and intensive care volume in ventilated patients from 1995 to 2009 in the Australian and New Zealand binational adult patient intensive care database*. Crit Care Med 40:800–812CrossRef
11.
go back to reference Fernandez R, Altaba S, Cabre L, Lacueva V, Santos A, Solsona JF, Anon JM, Catalan RM, Gutierrez MJ, Fernandez-Cid R, Gomez-Tello V, Curiel E, Fernandez-Mondejar E, Oliva JC, Tizon AI, Gonzalez J, Monedero P, Sanchez MG, de la Torre MV, Ibanez P, Frutos F, Del Nogal F, Gomez MJ, Marcos A, Vera P, Serrano JM, Umaran I, Carrillo A, Lopez-Pueyo MJ, Rascado P, Balerdi B, Suberviola B, Hernandez G, Sabadell Score G (2013) Relationship between volume and survival in closed intensive care units is weak and apparent only in mechanically ventilated patients. Anesthesiology 119:871–879PubMedCrossRef Fernandez R, Altaba S, Cabre L, Lacueva V, Santos A, Solsona JF, Anon JM, Catalan RM, Gutierrez MJ, Fernandez-Cid R, Gomez-Tello V, Curiel E, Fernandez-Mondejar E, Oliva JC, Tizon AI, Gonzalez J, Monedero P, Sanchez MG, de la Torre MV, Ibanez P, Frutos F, Del Nogal F, Gomez MJ, Marcos A, Vera P, Serrano JM, Umaran I, Carrillo A, Lopez-Pueyo MJ, Rascado P, Balerdi B, Suberviola B, Hernandez G, Sabadell Score G (2013) Relationship between volume and survival in closed intensive care units is weak and apparent only in mechanically ventilated patients. Anesthesiology 119:871–879PubMedCrossRef
12.
go back to reference Shahin J, Harrison DA, Rowan KM (2014) Is the volume of mechanically ventilated admissions to UK critical care units associated with improved outcomes? Intensive Care Med. doi:10.1007/s00134-013-3205-4 Shahin J, Harrison DA, Rowan KM (2014) Is the volume of mechanically ventilated admissions to UK critical care units associated with improved outcomes? Intensive Care Med. doi:10.​1007/​s00134-013-3205-4
13.
go back to reference Antonelli M, Bonten M, Chastre J, Citerio G, Conti G, Curtis JR, De Backer D, Hedenstierna G, Joannidis M, Macrae D, Mancebo J, Maggiore SM, Mebazaa A, Preiser JC, Rocco P, Timsit JF, Wernerman J, Zhang H (2012) Year in review in intensive care medicine 2011. II. Cardiovascular, infections, pneumonia and sepsis, critical care organization and outcome, education, ultrasonography, metabolism and coagulation. Intensive Care Med 38:345–358PubMedCentralPubMedCrossRef Antonelli M, Bonten M, Chastre J, Citerio G, Conti G, Curtis JR, De Backer D, Hedenstierna G, Joannidis M, Macrae D, Mancebo J, Maggiore SM, Mebazaa A, Preiser JC, Rocco P, Timsit JF, Wernerman J, Zhang H (2012) Year in review in intensive care medicine 2011. II. Cardiovascular, infections, pneumonia and sepsis, critical care organization and outcome, education, ultrasonography, metabolism and coagulation. Intensive Care Med 38:345–358PubMedCentralPubMedCrossRef
14.
go back to reference Antonelli M, Bonten M, Chastre J, Citerio G, Conti G, Curtis JR, De Backer D, Hedenstierna G, Joannidis M, Macrae D, Mancebo J, Maggiore SM, Mebazaa A, Preiser JC, Rocco P, Timsit JF, Wernerman J, Zhang H (2012) Year in review in intensive care medicine 2011: III. ARDS and ECMO, weaning, mechanical ventilation, noninvasive ventilation, pediatrics and miscellanea. Intensive Care Med 38:542–556PubMedCentralPubMedCrossRef Antonelli M, Bonten M, Chastre J, Citerio G, Conti G, Curtis JR, De Backer D, Hedenstierna G, Joannidis M, Macrae D, Mancebo J, Maggiore SM, Mebazaa A, Preiser JC, Rocco P, Timsit JF, Wernerman J, Zhang H (2012) Year in review in intensive care medicine 2011: III. ARDS and ECMO, weaning, mechanical ventilation, noninvasive ventilation, pediatrics and miscellanea. Intensive Care Med 38:542–556PubMedCentralPubMedCrossRef
15.
go back to reference Kahn JM (2013) What’s new in ICU volume–outcome relationships? Intensive Care Med 39:1635–1637PubMedCrossRef Kahn JM (2013) What’s new in ICU volume–outcome relationships? Intensive Care Med 39:1635–1637PubMedCrossRef
16.
go back to reference Harrison DA, Brady AR, Rowan K (2004) Case mix, outcome and length of stay for admissions to adult, general critical care units in England, Wales and Northern Ireland: the intensive care national audit & research centre case mix programme database. Crit Care 8:R99–R111PubMedCentralPubMedCrossRef Harrison DA, Brady AR, Rowan K (2004) Case mix, outcome and length of stay for admissions to adult, general critical care units in England, Wales and Northern Ireland: the intensive care national audit & research centre case mix programme database. Crit Care 8:R99–R111PubMedCentralPubMedCrossRef
17.
go back to reference Determann RM, Royakkers A, Wolthuis EK, Vlaar AP, Choi G, Paulus F, Hofstra JJ, de Graaff MJ, Korevaar JC, Schultz MJ (2010) Ventilation with lower tidal volumes as compared with conventional tidal volumes for patients without acute lung injury: a preventive randomized controlled trial. Crit Care 14:R1PubMedCentralPubMedCrossRef Determann RM, Royakkers A, Wolthuis EK, Vlaar AP, Choi G, Paulus F, Hofstra JJ, de Graaff MJ, Korevaar JC, Schultz MJ (2010) Ventilation with lower tidal volumes as compared with conventional tidal volumes for patients without acute lung injury: a preventive randomized controlled trial. Crit Care 14:R1PubMedCentralPubMedCrossRef
18.
go back to reference Gajic O, Dara SI, Mendez JL, Adesanya AO, Festic E, Caples SM, Rana R, St Sauver JL, Lymp JF, Afessa B, Hubmayr RD (2004) Ventilator-associated lung injury in patients without acute lung injury at the onset of mechanical ventilation. Crit Care Med 32:1817–1824PubMedCrossRef Gajic O, Dara SI, Mendez JL, Adesanya AO, Festic E, Caples SM, Rana R, St Sauver JL, Lymp JF, Afessa B, Hubmayr RD (2004) Ventilator-associated lung injury in patients without acute lung injury at the onset of mechanical ventilation. Crit Care Med 32:1817–1824PubMedCrossRef
19.
go back to reference Wunsch H, Wagner J, Herlim M, Chong DH, Kramer AA, Halpern SD (2013) ICU occupancy and mechanical ventilator use in the United States*. Crit Care Med 41:2712–2719PubMedCrossRef Wunsch H, Wagner J, Herlim M, Chong DH, Kramer AA, Halpern SD (2013) ICU occupancy and mechanical ventilator use in the United States*. Crit Care Med 41:2712–2719PubMedCrossRef
20.
go back to reference Tierney LT, Conroy KM (2013) Optimal occupancy in the ICU: a literature review. Aust Crit Care Off J Confed Aust Crit Care Nurses Tierney LT, Conroy KM (2013) Optimal occupancy in the ICU: a literature review. Aust Crit Care Off J Confed Aust Crit Care Nurses
Metadata
Title
Should mechanical ventilation care be centralized and should we thus transfer all ventilated patients to high volume units? Take a breath first
Authors
Marcus J. Schultz
Peter E. Spronk
Publication date
01-03-2014
Publisher
Springer Berlin Heidelberg
Published in
Intensive Care Medicine / Issue 3/2014
Print ISSN: 0342-4642
Electronic ISSN: 1432-1238
DOI
https://doi.org/10.1007/s00134-014-3216-9

Other articles of this Issue 3/2014

Intensive Care Medicine 3/2014 Go to the issue