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BACKGROUND: Compared with 10 years ago when our last survey was completed, the number of respiratory therapists (RTs) has increased markedly in mainland China. In addition, the education systems for RTs and the working environment have also changed. We aimed to describe the current status of respiratory care in mainland China. METHODS: A nationwide survey was initiated from August 15, 2016, to September 2, 2016, through network platforms. RESULTS: We obtained responses from 196 RTs, of whom, 30.6% graduated from a bachelor's degree program, 25.5% graduated from an associate's degree program, and 43.9% were nurses who transitioned to be RTs through 6-month on-the-job training programs. Among the 3 groups, no significant differences existed in the basic job responsibility, such as mechanical ventilation and aerosol therapy; however, bachelor's degree RT graduates participated more in bronchoscopy assistance (96% vs 78%, P = .002), extracorporeal membrane oxygenation management (42% vs 25%, P = .02), and pulmonary ultrasound (40% vs 15%, P < .001). There was no RT certification or licensure in mainland China at the time of the survey, so only 23% of bachelor's degree graduates and 42% of associate's degree graduates received a license through other professions. For the respondents' opinions on the obstacles of respiratory care profession development, the lack of licensure was a profound barrier for both degree graduates, whereas on-the-job training RTs deemed that insufficient recognition of the value of the respiratory care profession was the main obstacle. CONCLUSIONS: In mainland China, degree programs for students and on-the-job training for Experienced ICU nurses were 2 major ways to train RTs. The absence of credential and/or licensure and the lack of recognition of the value of an RT were deemed as the 2 key obstacles in the development of respiratory care profession. [ABSTRACT FROM AUTHOR]

BACKGROUND: Diaphragmatic dysfunction is often underdiagnosed and is among the risk factors for failed weaning. The purpose of this study was to determine the prevalence of diaphragmatic dysfunction diagnosed by B-niode ultrasonography and to determine whether prolonged weaning subjects with diaphragmatic dysfunction have increased duration of mechanical ventilation compared with those without diaphragmatic dysfunction. METHODS: This was a prospective observational study in mechanically ventilated subjects who failed >3 spontaneous breathing trials or required >7 d of weaning after the first spontaneous breathing trial. Diaphragm thickness was measured in the zone of apposition using a 6-13-MHz ultrasound transducer during a spontaneous breathing trial. The diaphragmatic thickening fraction was calculated as a percentage from the formula: (Thickness at peak inspiration -- thickness at end expiration)/thickness at end expiration. Intra-observer and inter-observer reliability were also evaluated. RESULTS: Forty-one subjects (24 males; 62.2 ± 15.9 y old) were included in the study. Of these, the prevalence of ultrasonographic diaphragmatic dysfunction (defined as diaphragmatic thickening fraction of <20% with inspiration) was 34.1% (« = 14). Subjects with diaphragmatic dysfunction had longer ventilation time after inclusion (293.4 ± 194.8 vs 145.1 ± 101.3 h, P = .02) and ICU stay (29.2 ± 11.4 vs 22.4 ± 7.7 d, P = .03) than subjects without diaphragmatic dysfunction. CONCLUSIONS: Diaphragmatic dysfunction as assessed by B-mode ultrasonography is common in subjects with prolonged weaning. Subjects with such diaphragmatic dysfunction show longer mechanical ventilation durations and ICU stays. [ABSTRACT FROM AUTHOR]