Aslam, Tayyba N; Klitgaard, Thomas L; Ahlstedt, Christian A O; Andersen, Finn H; Chew, Michelle S; Collet, Marie O; Cronhjort, Maria; Estrup, Stine; Fossum, Ole K; Frisvold, Shirin K; Gillmann, Hans-Joerg; Granholm, Anders; Gundem, Trine M; Hauss, Kristin; Hollenberg, Jacob; Huanca Condori, Maria E; Hästbacka, Johanna; Johnstad, Bror A; Keus, Eric; Kjaer, Maj-Brit N; ... (2023). A survey of preferences for respiratory support in the intensive care unit for patients with acute hypoxaemic respiratory failure. Acta anaesthesiologica Scandinavica, 67(10), pp. 1383-1394. Wiley-Blackwell 10.1111/aas.14317
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BACKGROUND
When caring for mechanically ventilated adults with acute hypoxaemic respiratory failure (AHRF), clinicians are faced with an uncertain choice between ventilator modes allowing for spontaneous breaths or ventilation fully controlled by the ventilator. The preferences of clinicians managing such patients, and what motivates their choice of ventilator mode, are largely unknown. To better understand how clinicians' preferences may impact the choice of ventilatory support for patients with AHRF, we issued a survey to an international network of intensive care unit (ICU) researchers.
METHODS
We distributed an online survey with 32 broadly similar and interlinked questions on how clinicians prioritise spontaneous or controlled ventilation in invasively ventilated patients with AHRF of different severity, and which factors determine their choice.
RESULTS
The survey was distributed to 1337 recipients in 12 countries. Of these, 415 (31%) completed the survey either fully (52%) or partially (48%). Most respondents were identified as medical specialists (87%) or physicians in training (11%). Modes allowing for spontaneous ventilation were considered preferable in mild AHRF, with controlled ventilation considered as progressively more important in moderate and severe AHRF. Among respondents there was strong support (90%) for a randomised clinical trial comparing spontaneous with controlled ventilation in patients with moderate AHRF.
CONCLUSIONS
The responses from this international survey suggest that there is clinical equipoise for the preferred ventilator mode in patients with AHRF of moderate severity. We found strong support for a randomised trial comparing modes of ventilation in patients with moderate AHRF.
Item Type: |
Journal Article (Original Article) |
|---|---|
Division/Institute: |
04 Faculty of Medicine > Department of Intensive Care, Emergency Medicine and Anaesthesiology (DINA) > Clinic of Intensive Care |
UniBE Contributor: |
Pfortmüller, Carmen, Schefold, Jörg Christian |
Subjects: |
600 Technology > 610 Medicine & health |
ISSN: |
0001-5172 |
Publisher: |
Wiley-Blackwell |
Language: |
English |
Submitter: |
Pubmed Import |
Date Deposited: |
25 Sep 2023 10:38 |
Last Modified: |
14 Oct 2023 00:16 |
Publisher DOI: |
10.1111/aas.14317 |
PubMed ID: |
37737652 |
Uncontrolled Keywords: |
acute hypoxaemic respiratory failure acute respiratory distress syndrome controlled ventilation invasive mechanical ventilation spontaneous ventilation survey |
BORIS DOI: |
10.48350/186528 |
URI: |
https://boris.unibe.ch/id/eprint/186528 |
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