Health care professionals' perceptions regarding the challenges of mechanical ventilation in the context of the COVID-19 pandemic

Background: The COVID-19 pandemic brought further evidence for the limited capacity of health systems to respond to demands. One of the critical factors is the demand for mechanical ventilation in the context of the COVID-19 pandemic. Objective: To evaluate health care professionals9 perceptions regarding the challenges faced in mechanical ventilation management during the COVID-19 pandemic in Federal District, Brazil. Results: 45 responses were received: 19 from the physicians (42.2%) and 26 from respiratory physiotherapists (57.8%). The mean age was 35±8 years and 62.2% female (n=28). The main challenges reported were having a team with adequate knowledge of mechanical ventilation (n=26, 57.8%), difficulty maintaining adequate sedation (n=25, 55.6%), and minimizing asynchrony (n=22, 48.9%). It is worth noting that factors that were of great concern at the beginning of the pandemic in Brazil were little reported by the health professionals, such as lack of mechanical ventilators (n=2, 4.4%) and excess of mechanically ventilated patients (n=10, 22.2%). Another aspect was the greater use of the prone position, with only five professionals reporting difficulties with its use (11.1%) Conclusion: The biggest challenges reported by professionals in mechanical ventilation in the context of the COVID-19 pandemic were having a team with adequate mechanical ventilation knowledge, maintaining adequate sedation, and asynchrony. The excess of patients in mechanical ventilation and the lack of mechanical ventilators were aspects less mentioned by the professionals in the Federal District, Brazil.