Objective: To investigate respiratory care equipment, operators and conditions of performance in intensive care units (ICU), with the aim of providing data for standardization and developing respiratory care in China.
Methods: A questionnaire survey was performed in one national and two international conferences in August, 2006. Four hundred and ninety-one doctors and nurses from 320 ICUs in 264 tertiary hospitals responded.
Results: Ratios of invasive and noninvasive mechanical ventilators to beds were 0.52:1 (2 189/4 185) and 0.16:1 (672/4 185), respectively. Of 320 ICUs, ratios of ICU equipped with ultrasound, jet nebulizers and MDI were 55.9% (179/320), 33.8% (108/320) and 12.1% (39/320), respectively, and percentages of doctors in charge of setting modes and parameters, weaning and extubation were 92.1%, 93.1%, 83.5%, respectively. Suction (93.9%), humidification (90.2%), aerosol therapy (91.6%) and circuit changing (83.7%) were nurses' duties. Among 491 responders, 40.9% of them implemented spontaneous breathing trials (SBT) before weaning, 13.4% were ignorant of it, and 12.8% never. 27.1% of ICU never monitored air temperature during invasive mechanical ventilation, 34.4% provided humidification by instilling or pumping saline continuously for those patients who were weaned from ventilators but not extubated, 55.6% checked ventilator before use. Ventilator circuits were changed once a week in 48.1%, 1-3 days in 25.0% and 3-5 days in 14.7%.
Conclusion: The quantity of ventilators in the ICU has increased, but other practical respiratory care equipment have not been used widely. Most of respiratory care services are still provided by nurses and doctors, lacking professional staffs. The management is evidently variable but without a standardized guideline.