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A survey of preferences for respiratory support in the intensive care unit for patients with acute hypoxaemic respiratory failure

A survey of preferences for respiratory support in the intensive care unit for patients with acute hypoxaemic respiratory failure


Title: A survey of preferences for respiratory support in the intensive care unit for patients with acute hypoxaemic respiratory failure
Author: 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.
... 37 more authors Show all authors
Date: 2023-11
Language: English
Scope: 12
Department: Other departments
Faculty of Medicine
Series: Acta Anaesthesiologica Scandinavica; 67(10)
ISSN: 0001-5172
DOI: 10.1111/aas.14317
Subject: Svæfinga- og gjörgæslulæknisfræði; acute hypoxaemic respiratory failure; acute respiratory distress syndrome; controlled ventilation; invasive mechanical ventilation; spontaneous ventilation; survey; Anesthesiology and Pain Medicine
URI: https://hdl.handle.net/20.500.11815/4501

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Citation:

Aslam , T N , Klitgaard , T L , Ahlstedt , C A O , Andersen , F H , Chew , M S , Collet , M O , Cronhjort , M , Estrup , S , Fossum , O K , Frisvold , S K , Gillmann , H J , Granholm , A , Gundem , T M , Hauss , K , Hollenberg , J , Huanca Condori , M E , Hästbacka , J , Johnstad , B A , Keus , E , Kjær , M B N , Klepstad , P , Krag , M , Kvåle , R , Malbrain , M L N G , Meyhoff , C S , Morgan , M , Møller , A , Pfortmueller , C A , Poulsen , L M , Robertson , A C , Schefold , J C , Schjørring , O L , Siegemund , M , Sigurðsson , M I , Sjövall , F , Strand , K , Stueber , T , Szczeklik , W , Wahlin , R R , Wangberg , H L , Wian , K A , Wichmann , S , Hofsø , K , Møller , M H , Perner , A , Rasmussen , B S & Laake , J H 2023 , ' A survey of preferences for respiratory support in the intensive care unit for patients with acute hypoxaemic respiratory failure ' , Acta Anaesthesiologica Scandinavica , vol. 67 , no. 10 , pp. 1383-1394 . https://doi.org/10.1111/aas.14317

Abstract:

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.

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Publisher Copyright: © 2023 The Authors. Acta Anaesthesiologica Scandinavica published by John Wiley & Sons Ltd on behalf of Acta Anaesthesiologica Scandinavica Foundation.

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