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Healthcare 2017, 5(3), 34; doi:10.3390/healthcare5030034

Pediatric Respiratory Support Technology and Practices: A Global Survey

1
Department of Pediatrics, University of Washington and Seattle Children’s, 4800 Sand Point Way NE, M/S FA.2.112 P.O. Box 5371, Seattle, WA 98105, USA
2
Departments of Global Health, Medicine, Epidemiology, and Pediatrics, University of Washington, 325 9th Avenue, Box 359909, Seattle, WA 98104, USA
3
Seattle Children’s Research Institute, Seattle, WA 98101, USA
Parts of this manuscript were presented as posters at the 8th Congress of World Federation of Pediatric Intensive and Critical Care Societies in June 2016 in Toronto, Canada.
*
Author to whom correspondence should be addressed.
Received: 24 May 2017 / Revised: 7 July 2017 / Accepted: 13 July 2017 / Published: 21 July 2017
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Abstract

Objective: This global survey aimed to assess the current respiratory support capabilities for children with hypoxemia and respiratory failure in different economic settings. Methods: An online, anonymous survey of medical providers with experience in managing pediatric acute respiratory illness was distributed electronically to members of the World Federation of Pediatric Intensive and Critical Care Society, and other critical care websites for 3 months. Results: The survey was completed by 295 participants from 64 countries, including 28 High-Income (HIC) and 36 Low- and Middle-Income Countries (LMIC). Most respondents (≥84%) worked in urban tertiary care centers. For managing acute respiratory failure, endotracheal intubation with mechanical ventilation was the most commonly reported form of respiratory support (≥94% in LMIC and HIC). Continuous Positive Airway Pressure (CPAP) was the most commonly reported form of non-invasive positive pressure support (≥86% in LMIC and HIC). Bubble-CPAP was used by 36% HIC and 39% LMIC participants. ECMO for acute respiratory failure was reported by 45% of HIC participants, compared to 34% of LMIC. Oxygen, air, gas humidifiers, breathing circuits, patient interfaces, and oxygen saturation monitoring appear widely available. Reported ICU patient to health care provider ratios were higher in LMIC compared to HIC. The frequency of respiratory assessments was hourly in HIC, compared to every 2–4 h in LMIC. Conclusions: This survey indicates many apparent similarities in the presence of respiratory support systems in urban care centers globally, but system quality, quantity, and functionality were not established by this survey. LMIC ICUs appear to have higher patient to medical staff ratios, with decreased patient monitoring frequencies, suggesting patient safety should be a focus during the introduction of new respiratory support devices and practices. View Full-Text
Keywords: oxygen; respiratory technology; mechanical ventilation; non-invasive mechanical ventilation; international health oxygen; respiratory technology; mechanical ventilation; non-invasive mechanical ventilation; international health
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MDPI and ACS Style

Arnim, A.-V.; Jamal, S.M.; John-Stewart, G.C.; Musa, N.L.; Roberts, J.; Stanberry, L.I.; Howard, C.R.A. Pediatric Respiratory Support Technology and Practices: A Global Survey. Healthcare 2017, 5, 34.

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