title: 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.
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 positive-pressure 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.
  
  
  CONCLUSIONS
  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.
authors.affiliation: Universidade Federal de São Paulo, School of Medicine, São Paulo, São Paulo, Brazil.
authors.forename: Lara Maris
authors.initials: LM
authors.lastname: Nápolis
authors.forename: Leila Mara
authors.initials: LM
authors.lastname: Jeronimo
authors.forename: Danila Vieira
authors.initials: DV
authors.lastname: Baldini
authors.forename: Michelle Pinheiro
authors.initials: MP
authors.lastname: Machado
authors.forename: Virgínia Aparecida
authors.initials: VA
authors.lastname: de Souza
authors.forename: Pedro
authors.initials: P
authors.lastname: Caruso
mesh_terms: D001938:Brazil; D002983:Clinical Competence / Q000706:statistics & numerical data*; D005260:Female; D006297:Health Services Accessibility / Q000706:statistics & numerical data*; D016304:Hospitals, Private / Q000706:statistics & numerical data; D006779:Hospitals, Public / Q000706:statistics & numerical data; D006784:Hospitals, Teaching / Q000706:statistics & numerical data; D006801:Humans; D007362:Intensive Care Units / Q000706:statistics & numerical data*; D008297:Male; D010564:Personnel, Hospital / Q000706:statistics & numerical data*; D011175:Positive-Pressure Respiration / Q000295:instrumentation / Q000592:standards / Q000706:statistics & numerical data; D011795:Surveys and Questionnaires; D014505:Urban Population