J Pediatr Intensive Care 2019; 08(04): 210-213
DOI: 10.1055/s-0039-1691838
Original Article
Georg Thieme Verlag KG Stuttgart · New York

Knowledge and Practice of the Concept of Driving Pressure: A Survey of Pediatric Intensivists in Brazil

José Colleti Jr
1   Department of Pediatrics, Hospital Santa Catarina, Pediatric Intensive Care Unit, São Paulo, São Paulo, Brazil
,
Orlei Araujo
1   Department of Pediatrics, Hospital Santa Catarina, Pediatric Intensive Care Unit, São Paulo, São Paulo, Brazil
,
Felipe Caino de Oliveira Rezende
1   Department of Pediatrics, Hospital Santa Catarina, Pediatric Intensive Care Unit, São Paulo, São Paulo, Brazil
2   Instituto de Oncologia Pediátrica, GRAACC, São Paulo, São Paulo, Brazil
,
Werther Brunow de Carvalho
1   Department of Pediatrics, Hospital Santa Catarina, Pediatric Intensive Care Unit, São Paulo, São Paulo, Brazil
3   Children's Institute, University of São Paulo, São Paulo, São Paulo, Brazil
› Author Affiliations
Funding None.
Further Information

Publication History

24 February 2019

20 April 2019

Publication Date:
28 May 2019 (online)

Abstract

The objective of this study was to investigate the knowledge and clinical practices of Brazilian pediatric intensivists in relation to usage of the concept of driving pressure. Knowledge and practice patterns were assessed using a survey tool. The overall response rate was 22.8% (84 of 369); 69% of physicians responded that they had sufficient knowledge on the concept of driving pressure but only 56% correctly answered to specific knowledge questions about it. The majority of respondents (72.6%) claim to use this concept in their clinical practice although pediatric data are insufficient to routinely support the practice. This also suggests a good degree of knowledge translation from adult studies.

 
  • References

  • 1 Conti G, Piastra M. Mechanical ventilation for children. Curr Opin Crit Care 2016; 22 (01) 60-66
  • 2 Kneyber MC, Zhang H, Slutsky AS. Ventilator-induced lung injury. Similarity and differences between children and adults. Am J Respir Crit Care Med 2014; 190 (03) 258-265
  • 3 Turner DA, Ofori-Amanfo G, Williford WL, Cheifetz IM. Lung protective ventilation: a summary of the current evidence from the 2012 American Association for Respiratory Care International Congress. Expert Rev Respir Med 2013; 7 (03) 209-212
  • 4 Amato MB, Meade MO, Slutsky AS. , et al. Driving pressure and survival in the acute respiratory distress syndrome. N Engl J Med 2015; 372 (08) 747-755
  • 5 Pediatric Acute Lung Injury Consensus Conference Group. Pediatric acute respiratory distress syndrome: consensus recommendations from the Pediatric Acute Lung Injury Consensus Conference. Pediatr Crit Care Med 2015; 16 (05) 428-439
  • 6 Kneyber MCJ, de Luca D, Calderini E. , et al; section Respiratory Failure of the European Society for Paediatric and Neonatal Intensive Care. Recommendations for mechanical ventilation of critically ill children from the Paediatric Mechanical Ventilation Consensus Conference (PEMVECC). Intensive Care Med 2017; 43 (12) 1764-1780
  • 7 Cheifetz IM. Pediatric ARDS. Respir Care 2017; 62 (06) 718-731
  • 8 Sullivan GM, Artino Jr AR. Analyzing and interpreting data from likert-type scales. J Grad Med Educ 2013; 5 (04) 541-542
  • 9 Chiumello D, Carlesso E, Brioni M, Cressoni M. Airway driving pressure and lung stress in ARDS patients. Crit Care 2016; 20: 276
  • 10 Panico FF, Troster EJ, Oliveira CS. , et al. Risk factors for mortality and outcomes in pediatric acute lung injury/acute respiratory distress syndrome. Pediatr Crit Care Med 2015; 16 (07) e194-e200
  • 11 Yehya N, Thomas NJ. Disassociating lung mechanics and oxygenation in pediatric acute respiratory distress syndrome. Crit Care Med 2017; 45 (07) 1232-1239
  • 12 Inata Y, Takeuchi M. Does driving pressure matter in pediatric acute respiratory distress syndrome? Strain to find the answer. Crit Care Med 2017; 45 (11) e1196-e1197
  • 13 Grimshaw JM, Eccles MP, Lavis JN, Hill SJ, Squires JE. Knowledge translation of research findings. Implement Sci 2012; 7: 50
  • 14 Santschi M, Randolph AG, Rimensberger PC, Jouvet P. ; Pediatric Acute Lung Injury Mechanical Ventilation Investigators; Pediatric Acute Lung Injury and Sepsis Investigators Network; European Society of Pediatric and Neonatal Intensive Care. Mechanical ventilation strategies in children with acute lung injury: a survey on stated practice pattern*. Pediatr Crit Care Med 2013; 14 (07) e332-e337
  • 15 Neto AS, Hemmes SN, Barbas CS. , et al; PROVE Network Investigators. Association between driving pressure and development of postoperative pulmonary complications in patients undergoing mechanical ventilation for general anaesthesia: a meta-analysis of individual patient data. Lancet Respir Med 2016; 4 (04) 272-280