The comparative analysis of the common reasons of invasive ventilator alarms between medical and specialist intensive care unit

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Author:
TAN Wei(Department of Medical Intensive Care Unit, the First Hospital of China Medical University, Shenyang 110001,Liaoning, China)
SUN Long-feng(Department of Medical Intensive Care Unit, the First Hospital of China Medical University, Shenyang 110001,Liaoning, China)
QIN Zheng(Department of Medical Intensive Care Unit, the First Hospital of China Medical University, Shenyang 110001,Liaoning, China)
DAI Bing(Department of Medical Intensive Care Unit, the First Hospital of China Medical University, Shenyang 110001,Liaoning, China)
ZHAO Hong-wen(Department of Medical Intensive Care Unit, the First Hospital of China Medical University, Shenyang 110001,Liaoning, China)
KANG Jian(Department of Medical Intensive Care Unit, the First Hospital of China Medical University, Shenyang 110001,Liaoning, China)
Journal Title:
Chinese Critical Care Medicine
Issue:
Volume 24, Issue 10, 2012
DOI:
10.3760/cma.j.issn.1003-0603.2012.10.003
Key Word:
Medical intensive care unit; Specialist intensive care unit; Ventilator alarm; Mechanical ventilation

Abstract: Objective To analyze the common reasons of invasive ventilator alarms between medical intensive care unit (ICU) and specialist ICU,and its related management methods.Methods Patients admitted to medical ICU and specialist ICU from January to December in 2011 of the First Hospital of China Medical University were studyed.Ventilator alarms and their reasons need to be handle by the front-line doctors,respiratory therapists,attending physicians or medical ICU doctors were analyzed and compared.Results There were 375 ventilator alarms of the 59 patients in the medical ICU,incidence of the top three alarms parameters were high airway pressure alarms for 21.87%,high tide volume alarms for 15.73% and high minute ventilation alarms for 14.13%.In specialist ICU there were a total of 403 ventilator alarms with 249 patients,incidence of the top three alarms parameters were high airway pressure alarms for 32.51%,low airway pressure alarms for 15.38%,high respiratory rate alarms for 10.42%.The incidence of high airway pressure and low airway pressure alarms in medical ICU were significantly lower than the specialist ICU (21.87%vs.32.51%,8.53% vs.15.38%,both P<0.01),and the incidence of high minute ventilation and high tidal volume alarms in medical ICU were higher than specialist ICU (14.13% vs.7.20%,15.73% vs.9.68%,P<0.01 and P<0.05).The top three causes of the alarms were aerosol inhalation,sputum blockage,and oxygen battery expired in medical ICU,and sputum blockage,respiratory distress,and pipeline leak and oxygen expired battery in specialist ICU.The reasons of sputum blockage,tubes factors (intubation position change,pipeline water) and improper alarm parameters setting in medical ICU was significantly lower than those in specialist ICU ( 10.93% vs.17.12%,1.87% vs.4.47%,1.33% vs.3.72%,1.60% vs.3.97%,all P<0.05).High tidal volume,high minute ventilation and serious breath-side filter blockage because of aerosol inhalation in medical ICU were significantly higher than those in specialist ICU ( 18.93% vs.3.97%,P<0.01 ).Conclusion Doctors in medical ICU and specialist ICU should understand the ventilator alarms characteristics,prevention,detect and timely problems management.

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