Abstract
Background: Ventilators for invasive and non-invasive respiratory support have the ability to store and transmit data. Many outpatient clinics, long term care facilities, and home care agencies use the data download feature to retrieve ventilator data remotely and make changes as needed. In these environments, daily assessment of the ventilator by a respiratory therapist (RT) is not always feasible. In the hospital setting, RT assessment is the norm, with data downloads not utilized frequently to make ventilator changes. We evaluated concurrent stored Trilogy 202 ventilator data and RT documented ventilator checks to determine if differences were present.
Methods: After obtaining IRB approval, 10 patients were selected randomly if they met our inclusion criteria of Trilogy 202 ventilator use for >7 days and a minimum 12 hour per day ventilator use. Data from the ventilator’ SD card was analyzed and compared to concurrent RT documentation in the EMR. Variables for analysis included breaths/min, leak, minute volume (MV), tidal volume (VT), and peak inspiratory pressure (PIP) .Averages for each parameter for each patient were recorded. Variable mean and standard deviations were determined and compared using paired T-tests.
Results: The average patient age was 2.98 years. 5/10 patients had uncuffed tracheostomy tubes. 4 patients received SIMV PC PS, 3 CPAP/PS, 2 PC, and 1 CPAP. There was a statistically significant difference in SD card obtained data when compared to RT documentation 10% of the time for breaths/min, 40% of the time for leak, 20% of the time for MV, 30% of the time for VT and 10% of the time for PIP (Table 1). Overall, in 22% of comparisons there was a statistically significant difference between SD card data and RT documentation for the measured parameters. For the 10 patients studied, 6 patients (60%) had a statistically significant change in one or more of the compared variables. See graph 1 and Table 2 for additional data.
Conclusions: In our practice, significant differences are present between Trilogy 202 ventilator SD card data and RT documentation. Based on the design of this study we are unable to conclude if Trilogy 202 recorded data or RT documented data is preferred. Further studies must be done to evaluate the significance of these differences as it is applied to ventilator adjustments and patient outcomes.
Graph 1 displays the variables for analysis comparing the Trilogy 202 SD Card data trends and the average RT electronic health record documentation.
Footnotes
Commercial Relationships: K. Burr- Hill-Rom, Patient Trainer
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