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Assessment of artificial ventilation in Salvadorian public hospitals
Critical Care volume 15, Article number: P516 (2011)
Artificial ventilation (AV) is an essential resource that is not always available at Salvadorian public hospitals. Approximately 40% of hospital-related deaths may have required AV . The main indication for AV is respiratory insufficiency requiring support for these patients. Variations in ventilation modality and time among others can affect patient health . The aim of this study was to clarify the AV situation in national hospitals of El Salvador's public health system.
This study is transversal descriptive. A representative sample (n = 5) of public national hospitals was selected. These included four second-level hospitals and one third-level hospital. Two hospitals were from the central metropolitan region, one from the par central, west and east region; representing 36.1% of available hospital beds nationwide. To complete AV data of the totality of public hospitals, a telephone survey was used. All data about patients, AV type, costs, maintenance and operative personnel, among others, were collected.
Only 18% of all public hospitals around the country have mechanical AV. The majority of mechanical AV on the public health network is focused on Rosales National Hospital (HNR), with 61.9% of mechanical ventilators nationwide. Mechanical AV is operated by respiratory therapy personnel at HNR and Zacamil National Hospital; however, in another two hospitals from the east and west region, mechanical AV is operated by residents; and manual AV is provided by self-inflating resuscitator bag operated by interns only. The main causes of AV are nonsurgical; representing 88.9% of the reasons to employ mechanical AV, and 100% for manual AV. The mean patient ventilation time for mechanical AV was >48 hours, and for manual AV was >24 hours. No patient with manual AV had normal pO2. The maintenance cost for all mechanical AV was less than $100 per month per ventilator and only 68% of mechanical ventilators were functional, the most frequent model being Servo900.
The actual mechanical AV existence is very limited, since only four out of 14 departments have this resource, representing 18% of public health centers nationwide, centralized in the department of San Salvador, leaving 82% of these centers with no mechanical ventilation at all, being probably supplanted by manual AV. Results show the necessity for cheaper, efficient and easy-to-use AV systems.
Peleg AY, et al.: N Engl J Med. 2010, 362: 1804-1813.
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Granados, J., Sobenes, P. & Bertoli, M. Assessment of artificial ventilation in Salvadorian public hospitals. Crit Care 15, P516 (2011). https://doi.org/10.1186/cc9936
- Public Hospital
- National Hospital
- Public Health System
- Metropolitan Region
- Artificial Ventilation