Year: 2016
Type: dissertation
Study design: Observational Study
Abstract: OBJECTIVES: To evaluate use of adjuvants to mechanical ventilation for acute respiratory failure (ARF;2008-2013) and the impact of landmark publications on adoption and de-adoption. METHODS: Adult patients with ARF who underwent mechanical ventilation were evaluated using a large US quality improvement database. Adjuvant use was identified using International Classification of Disease, 9th Edition codes and billing data. RESULTS: Among 514,913 ARF patients, 11,567 (2.3%) were treated with adjuvants. There was an increase in recent years of extracorporeal membrane oxygenation and inhaled epoprostenol but no change in inhaled nitric oxide or continuous paralysis over time. Segmented regression analysis used to evaluate whether clinical practice was in accordance with evidence from landmark studies, did not reveal any change in use following publication with the exception of inhaled epoprostenol. CONCLUSIONS: The use of adjuvants is infrequent across our population. Published evidence to support current adoption/de-adoption appear to have had limited effect on practice.
Source: TSpace (University of Toronto)
Author: Laveena Munshi
Language: English
Subfield: Pulmonary and Respiratory Medicine
Field: Medicine
Domain: Health Sciences
Open Access status: green
OpenAlex ID: W2768276251