Investigation on the Current Status of ICU Nurses' Management of Mechanical Ventilation in Adult Patients after Cardiovascular Surgery with CPB

Wang Yi; Qiu Luxin; Zi Mingjiao

doi:10.3969/j.issn.1006-7256.2024.18.002

Abstract：Objective:To investigate the current status of clinical practice of ICU nurses in the management of mechanical ventilation in adult patients after cardiovascular surgery with cardiopulmonary bypass(CPB).Methods:A cross-sectional questionnaire survey was con-ducted from April 1 to June 1,2023.Electronic survey questionnaires were sent to nurses in cardiac surgery intensive care units(CSICU)of 36 medical institutions in 15 provinces,autonomous regions and municipalities in China,and the survey results were analyzed.Results:A total of 132 valid questionnaires were collected,and the effective recovery rate was 99.25% .Among the initial mechanical ventilation modes after cardiac surgery,the volume trigger ventilation mode accounted for 60.61%,the pressure trigger ventilation mode accounted for 19.70%,and the new ventilation mode compatible with the two trigger advantages accounted for 15.91% .In the initial setting of tidal vol-ume after cardiac surgery,the standard body weight of 81 patients(61.36% )was used to calculate tidal volume.About the setting of PEEP,60(45.45% )nurses chose 5 cm H2 O.The management(44.70% )of mechanical ventilation was administered by doctors,41.66% was left to doctors/nurses through coordinated adjustment,9.09% left to respiratory therapists,and 4.55% led by nurses.CPAP was 42.42%,SIMV was 37.12%,PSV was 8.33%,SPONT and others were 12.12% at the time of weaning from mechanical ventilation.Abid-ing by standardized process of weaning from mechanical ventilation,100.00% of the patients underwent spontaneous breathing test,71.97% underwent the removal of secretions by airbag of tracheal incubation,35.61% underwent the airbag leak test,33.33% underwent the maximum inspiratory pressure monitoring,and 30.30% underwent the peak cough flow detection.Conclusion:Most CSICU nurses have certain professional knowledge of mechanical ventilation management in adult patients after cardiovascular surgery with CPB,but great differences exist in clinical practice.Therefore guidance documents such as relevant guidelines/expert consensus are urgently needed.