• Journal of critical care · Feb 2015

    Prolonged mechanical ventilation in Canadian intensive care units: A national survey.

    • Louise Rose, Robert A Fowler, Eddy Fan, Ian Fraser, David Leasa, Cathy Mawdsley, Cheryl Pedersen, Gordon Rubenfeld, and CANuVENT group.
    • Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Toronto, Ontario, Canada M5T 1P8; Provincial Centre of Weaning Excellence/Prolonged Ventilation Weaning Centre, Toronto East General Hospital, Toronto, Ontario, Canada M4C 3E7; Mt. Sinai Hospital, Toronto, Ontario, Canada M5G 1X5; Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, Ontario, Canada M5B 1W8; Department of Critical Care, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada M4N 3M5; Sunnybrook Research Institute, Toronto, Ontario, Canada M4N 3M5. Electronic address: louise.rose@utoronto.ca.
    • J Crit Care. 2015 Feb 1;30(1):25-31.

    BackgroundWe sought to describe prevalence and care practices for patients experiencing prolonged mechanical ventilation (PMV), defined as ventilation for 21 or more consecutive days and medical stability.MethodsWe provided the survey to eligible units via secure Web link to a nominated unit champion from April to November 2012. Weekly telephone and e-mail reminders were sent for 6 weeks.ResultsResponse rate was 215 (90%) of 238 units identifying 308 patients requiring PMV on the survey day occupying 11% of all Canadian ventilator-capable beds. Most units (81%) used individualized plans for both weaning and mobilization. Weaning and mobilization protocols were available in 48% and 38% of units, respectively. Of those units with protocols, only 25% reported weaning guidance specific to PMV, and 11% reported mobilization content for PMV. Only 30% of units used specialized mobility equipment. Most units referred to speech language pathologists (88%); use of communication technology was infrequent (11%). Only 29% routinely referred to psychiatry/psychology, and 17% had formal discharge follow-up services.ConclusionsProlonged mechanical ventilation patients occupied 11% of Canadian acute care ventilator bed capacity. Most units preferred an individualized approach to weaning and mobilization with considerable variation in weaning methods, protocol availability, access to specialized rehabilitation equipment, communication technology, psychiatry, and discharge follow-up.Copyright © 2014 Elsevier Inc. All rights reserved.

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