Availability and use of noninvasive ventilation in the intensive care units of public, private and teaching hospitals in the greater metropolitan area of São Paulo, Brazil* LARA MARIS NÁPOLIS1, LEILA MARA JERONIMO2, DANILA VIEIRA BALDINI3,

* Study carried out at the University of Hospital do Câncer (Cancer Hospital), São Paulo, São Paulo, Brazil 1. Masters in Physiotherapy from the Universidade Federal de São Paulo (UNIFESP, Federal University of São Paulo) School of Medicine, São Paulo, São Paulo, Brazil 2. Masters in Physiotherapy from the University of São Paulo (USP) School of Medicine, São Paulo, São Paulo, Brazil 3. Physiotherapist at the University of São Paulo (USP) School of Medicine Hospital das Clínicas, São Paulo, São Paulo, Brazil 4. Attending physician in the Respiratory ICU of the University of São Paulo (USP) School of Medicine Hospital das Clínicas, São Paulo, São Paulo, Brazil; Physician in the ICU of the Hospital do Câncer (Cancer Hospital), São Paulo, São Paulo, Brazil Correspondence to: Pedro Caruso. Unidade de Terapia Intensiva de Adultos. R. Prof. Antonio Prudente 211, Liberdade CEP: 01509-010, São Paulo, SP, Brasil. Submitted: 20 March 2005. Accepted, after review: 1 July 2005. ABSTRACT Objective: To determine the availability of noninvasive positive-pressure ventilation equipment, as well as the level of expertise and familiarity of physicians, nurses and physiotherapists with noninvasive positive-pressure ventilation in the intensive care units of public, private and teaching hospitals in the greater metropolitan area of São Paulo, Brazil. Methods: On-site administration of questionnaires. Results: Noninvasive positive-pressure ventilation equipment was widely available and was more commonly found in private hospitals than in teaching hospitals. Such equipment was least available in public hospitals, in which the predominant method was the use of mechanical ventilators designed for invasive ventilation and adapted to noninvasive positivepressure ventilation. In private hospitals, continuous flow ventilators were more common, whereas, in teaching hospitals, ventilators specifically designed for noninvasive ventilation were typically employed. All physiotherapists felt themselves capable of initiating noninvasive positive pressure ventilation, compared with 72.6% of physicians and 33.3% of nurses. Physicians and physiotherapists presented high percentages of correct answers when asked about the indications and contraindications for the use of noninvasive positive-pressure ventilation. Over a one year period, more physiotherapists read articles about noninvasive positive-pressure ventilation and participated in related classes than did physicians, who in turn did so more than did nurses. Conclusion: Noninvasive positive-pressure ventilation equipment is widely available in the greater metropolitan area of São Paulo, although differences exist among public, private and teaching hospitals in terms of the type of equipment used. Physicians and physiotherapists exhibited considerable knowledge regarding the indications and contraindications for the use of noninvasive positive-pressure ventilation. More physiotherapists felt themselves able to initiate noninvasive positive-pressure ventilation, and their knowledge of the subject was more current than was that of physicians or nurses.