Thursday, August 2, 2012

Spencer Park Wk7

This week was mostly spent working on the research project. After finally collecting all the necessary data for our study on the effect of ventilatory modes on the recovery of patients with respiratory failures. The data from patients before the summer of 2007 (when Eclipsys was converted to the newer version) was collected after getting special access to the old software, which of course took very long. Data from patients admitted between 2002 and 2006 had already been retrieved by the respiratory therapist at the burn ICU so I could use it for my study. Now I have close to 450 patients on my list and I am in the process of analyzing for the difference between APRV and what we call 'conventional ventilation'. Before 2004, APRV was not used at the burn ICU and was very rare in the U.S. Hence, anyone with severe respiratory problems were put on increased PEEP, usually 15 or higher. However, starting in 2004, APRV replaced conventional ventilators using PEEPs > 15. Gradually, the use of APRV increased in the burn ICU and by 2007, APRV was more widely used, even on patients without severe respiratory difficulties. Therefore, I am analyzing my data to see if the substitution of conventional ventilation with PEEP > 15 with APRV has had any significant effect on patient recovery. So far, the analyses of the data points between 2011 and 2006 shows that APRV is at least just as good as conventional ventilators and makes a strong case that it should be used as widely.

Outside of my research project, I observed Dr. Bessey perform skin allograft on the female patient who had necrotizing fasciitis. Though the surgery went smoothly, he expects there to be a higher chance of one of the grafts not taking since there is so much void space below the skin grafts. However, she and her family were all very happy that she made such great progress after the first two weeks of her stay, when the infection was spreading too fast and things didn't look very optimistic.

After speaking with Dr. Bessey before leaving NYC, it seems I will be making a few trips down to the city during the fall semester to continue the study on the ventilators.

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