Abstract
Background:
A nationally qualified respiratory therapist is not established in Japan. Rather, respiratory care therapies are provided by a team of interdisciplinary healthcare providers. The purpose of this descriptive investigation was to examine the impact of the Respiratory Support Team (RST) at a facility by measuring the mortality rate, reintubation rate, and lengths of ventilation days since provide healthcare providers with the ventilatory guideline and education from RST.
Methods:
A retrospective chart review was conducted which compared two groups of over 48-hours ventilated patients with bacterial pneumonia one year before and one year after the 2010 formation of the RST to explore the mortality rate, reintubation rate, and lengths of ventilated days and determine whether the utilization of a team-based approach to ventilatory management improved outcomes at this facility. The study site was a 341-bed hospital in Osaka, Japan. Twenty-one ventilated patients identified the year preceding formation of the RST (April 12, 2019- for a year before April 30, 2010) were enrolled in the comparison group. Twenty-one ventilated patients fitting the inclusion criteria and admitted the year immediately following the initiation of the RST (May 1, 2016-August 12, 2017) were enrolled in an intervention group. The study population included adult patients who were diagnosed with pneumonia, admitted to the ICU, and who were intubated for over 48 hours. A retrospective review of charts identified a sample of patients fitting the inclusion criteria.
Results:
There was a significant difference between the mortality rates (61.9 % vs 38.1 %) and survival rate (28.6 % vs 71.4 %) between the intervention group and the comparison group (P <.05). There was a significant difference in the reintubation rates (23.8% vs 0%) between the two groups. It was associated with a decrease in lengths of ventilation days for pneumonia patients.
Conclusions:
The ventilatory guideline for a patient receiving mechanical ventilation and the education from RST were effective in reducing the rates of both reintubation and mortality.
Table 1
Comparison group n=21
Intervention group n=21
Male (n)
90.5%(19)
71.4%(15)
Age, mean (±SD)
75(10)
73(13)
Table 2
Comparison group n=21
Intervention group n=21
p Value
Mortality rate, n(%)
13 (61.9)
6 (28.6)
0.03
Reintubation rate, n(%)
5 (23.8)
0 (0)
0.017
Ventilated days, mean±SD
27.33 (34)
14.33 (13.9)
0.113
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