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

doi:10.1111/aas.14317

Randomized Controlled Trial

. 2023 Nov;67(10):1383-1394.

doi: 10.1111/aas.14317. Epub 2023 Sep 22.

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

Tayyba N Aslam^{1

2

3}, Thomas L Klitgaard⁴, Christian A O Ahlstedt⁵, Finn H Andersen⁶, Michelle S Chew⁷, Marie O Collet⁸, Maria Cronhjort⁹, Stine Estrup¹⁰, Ole K Fossum¹¹, Shirin K Frisvold¹², Hans-Joerg Gillmann¹³, Anders Granholm⁸, Trine M Gundem¹⁴, Kristin Hauss¹⁵, Jacob Hollenberg¹⁶, Maria E Huanca Condori¹⁷, Johanna Hästbacka¹⁸, Bror A Johnstad¹⁹, Eric Keus²⁰, Maj-Brit N Kjaer⁸, Pål Klepstad²¹, Mette Krag²², Reidar Kvåle²³, Manu L N G Malbrain²⁴, Christian S Meyhoff²⁵, Matt Morgan²⁶, Anders Møller²⁵, Carmen A Pfortmueller²⁷, Lone M Poulsen²⁸, Andrew C Robertson²⁹, Joerg C Schefold³⁰, Olav L Schjørring⁴, Martin Siegemund³¹, Martin I Sigurdsson³², Fredrik Sjövall³³, Kristian Strand³⁴, Thomas Stueber³⁵, Wojciech Szczeklik³⁶, Rebecka R Wahlin^{37

38}, Helge L Wangberg³⁹, Karl-Andre Wian⁴⁰, Sine Wichmann⁴¹, Kristin Hofsø², Morten H Møller⁸, Anders Perner⁸, Bodil S Rasmussen⁴, Jon H Laake^{1

2}; SVALBARD investigators

Collaborators, Affiliations

Collaborators

SVALBARD investigators:
Christian A O Ahlstedt, Finn H Andersen, Tayyba N Aslam, Stephan Balsliemke, Heidi Bergsvåg, Emil Berta, Tron E Blien, Peter Bohge, Michelle S Chew, Marie O Collet, Maria Cronhjort, Vegard T Dokka, Stine Estrup, Ole K Fossum, Shirin K Frisvold, Hans-Joerg Gillmann, Anders Granholm, Trine M Gundem, Rønnaug Hammervold, Kristin Hauss, Kristin Hofsø, Jacob Hollenberg, Peter J Holm, Maria E Huanca Condori, Johanna Hästbacka, Bror A Johnstad, Eric Keus, Maj-Brit N Kjaer, Pål Klepstad, Thomas L Klitgaard, Mette Krag, Reidar Kvåle, Per Johan Lans, Jon H Laake, Manu L N G Malbrain, Ole Mathiesen, Christian S Meyhoff, Matt Morgan, Anders Møller, Morten Hylander Møller, Thomas C R Olsen, Robert Pedersen, Anders Perner, Carmen A Pfortmueller, Lone M Poulsen, Bodil S Rasmussen, Andrew C Robertson, Joerg C Schefold, Olav L Schjørring, Martin Siegemund, Martin I Sigurdsson, Fredrik Sjövall, Hod Stern, Kristian Strand, Thomas Stueber, Wojciech Szczeklik, Rebecka R Wahlin, Helge L Wangberg, Karl-Andre Wian, Sine Wichmann, Robert Winding

Affiliations

¹ Department of Anaesthesiology and Intensive Care Medicine, Division of Emergencies and Critical Care, Rikshopitalet, Oslo University Hospital, Oslo, Norway.
² Department of Research and Development, Division of Emergencies and Critical Care, Oslo University Hospital, Oslo, Norway.
³ Institute of Clinical Medicine, University of Oslo, Oslo, Norway.
⁴ Department of Anaesthesia and Intensive Care, Aalborg University Hospital, Aalborg, Denmark.
⁵ Perioperative Medicine and Intensive Care, Karolinska University Hospital Huddinge, Stockholm, Sweden.
⁶ Anaesthesia and Intensive Care, Ålesund Hospital, Ålesund, Norway.
⁷ Department of Anaesthesia and Intensive Care, Biomedical and Clinical Sciences, Linköping University Hospital, Linköping, Sweden.
⁸ Department of Intensive Care 4131, Rigshospitalet-Copenhagen University Hospital, Copenhagen, Denmark.
⁹ Department of Clinical Science, Danderyds Sjukhus, Karolinska Institutet, Stockholm, Sweden.
¹⁰ Intensive Care, Rigshospitalet, Copenhagen, Denmark.
¹¹ Anaesthesia and Intensive Care, Akershus University Hospital, Nordbyhagen, Norway.
¹² Anesthesiology and Intensive Care, University Hospital of North Norway, Tromsø, Norway.
¹³ Anesthesiology and Intensive Care Medicine, Hannover Medical School, Hannover, Germany.
¹⁴ Anaesthesiology and Intensive Care Medicine, Ullevål, Oslo University Hospital, Oslo, Norway.
¹⁵ Acute- and Emergency Medicine, Sykehuset Telemark, Skien, Norway.
¹⁶ Department of Cardiology, Medical Intensive Care Unit, Karolinska Institutet, Stockholm, Sweden.
¹⁷ Anaesthesia and Intensive Care, Helse Fonna, Haugesund, Norway.
¹⁸ Department of Perioperative and Intensive Care Medicine, University of Helsinki and Helsinki University Hospital, Helsinki, Finland.
¹⁹ Acute Medicine, Sykehuset Innlandet Hamar, Hamar, Norway.
²⁰ Critical Care, University Medical Center Groningen, Groningen, Netherlands.
²¹ Intensive Care Medicine, St Olavs University Hospital, Trondheim, Norway.
²² Department of Anaesthesiology, Holbaek Hospital, Holbaek, Denmark.
²³ Anaesthesia and Intensive Care, Haukeland University Hospital, Bergen, Norway.
²⁴ First Department of Anaesthesiology and Intensive Therapy, Medical University of Lublin, Lublin, Poland.
²⁵ Department of Anaesthesia and Intensive Care, Copenhagen University Hospital-Bispebjerg and Frederiksberg, Copenhagen, Denmark.
²⁶ Adult Intensive Care, The Royal Perth Hospital, Perth, Western Australia, Australia.
²⁷ Department of Intensive Care, Inselspital, Bern University Hospital and University of Bern, Bern, Switzerland.
²⁸ Intensive Care Unit, Zealand University Hospital, Køge, Denmark.
²⁹ Anaesthesia and Intensive Care, Baerum Hospital, Baerum, Norway.
³⁰ Department of Intensive Care Medicine, Inselspital, University of Bern, Bern, Switzerland.
³¹ Intensive Care, University Hospital Basel, Basel, Switzerland.
³² Anaesthesiology and Intensive Care Medicine, Landspital-The National University Hospital of Iceland, Reykjavik, Iceland.
³³ Intensive and Perioperative Care, Skane University Hospital, Malmö, Sweden.
³⁴ Intensive Care, Stavanger University Hospital, Stavanger, Norway.
³⁵ Department of Anaesthesiology and Intensive Care, Hannover Medical School, Hannover, Germany.
³⁶ Center for Intensive Care and Perioperative Medicine, Jagiellonian University Medical College, Krakow, Poland.
³⁷ Department of Anaesthesia and Intensive Care, Södersjukhuset, Karolinska Institutet, Stockholm, Sweden.
³⁸ Department of Clinical Science and Education, Södersjukhuset, Karolinska Institutet, Stockholm, Sweden.
³⁹ Department of Anaesthesia, Volda Hospital, Volda, Norway.
⁴⁰ Anaesthesia and Intensive Care, Vestfold Hospital Trust, Tønsberg, Norway.
⁴¹ Department of Anaesthesia and Intensive Care, Copenhagen University Hospital-North Zealand, Hillerød, Denmark.

PMID: 37737652
DOI: 10.1111/aas.14317

Free article

Randomized Controlled Trial

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

Tayyba N Aslam et al. Acta Anaesthesiol Scand. 2023 Nov.

Free article

. 2023 Nov;67(10):1383-1394.

doi: 10.1111/aas.14317. Epub 2023 Sep 22.

Authors

Collaborators

SVALBARD investigators:
Christian A O Ahlstedt, Finn H Andersen, Tayyba N Aslam, Stephan Balsliemke, Heidi Bergsvåg, Emil Berta, Tron E Blien, Peter Bohge, Michelle S Chew, Marie O Collet, Maria Cronhjort, Vegard T Dokka, Stine Estrup, Ole K Fossum, Shirin K Frisvold, Hans-Joerg Gillmann, Anders Granholm, Trine M Gundem, Rønnaug Hammervold, Kristin Hauss, Kristin Hofsø, Jacob Hollenberg, Peter J Holm, Maria E Huanca Condori, Johanna Hästbacka, Bror A Johnstad, Eric Keus, Maj-Brit N Kjaer, Pål Klepstad, Thomas L Klitgaard, Mette Krag, Reidar Kvåle, Per Johan Lans, Jon H Laake, Manu L N G Malbrain, Ole Mathiesen, Christian S Meyhoff, Matt Morgan, Anders Møller, Morten Hylander Møller, Thomas C R Olsen, Robert Pedersen, Anders Perner, Carmen A Pfortmueller, Lone M Poulsen, Bodil S Rasmussen, Andrew C Robertson, Joerg C Schefold, Olav L Schjørring, Martin Siegemund, Martin I Sigurdsson, Fredrik Sjövall, Hod Stern, Kristian Strand, Thomas Stueber, Wojciech Szczeklik, Rebecka R Wahlin, Helge L Wangberg, Karl-Andre Wian, Sine Wichmann, Robert Winding

Affiliations

¹ Department of Anaesthesiology and Intensive Care Medicine, Division of Emergencies and Critical Care, Rikshopitalet, Oslo University Hospital, Oslo, Norway.
² Department of Research and Development, Division of Emergencies and Critical Care, Oslo University Hospital, Oslo, Norway.
³ Institute of Clinical Medicine, University of Oslo, Oslo, Norway.
⁴ Department of Anaesthesia and Intensive Care, Aalborg University Hospital, Aalborg, Denmark.
⁵ Perioperative Medicine and Intensive Care, Karolinska University Hospital Huddinge, Stockholm, Sweden.
⁶ Anaesthesia and Intensive Care, Ålesund Hospital, Ålesund, Norway.
⁷ Department of Anaesthesia and Intensive Care, Biomedical and Clinical Sciences, Linköping University Hospital, Linköping, Sweden.
⁸ Department of Intensive Care 4131, Rigshospitalet-Copenhagen University Hospital, Copenhagen, Denmark.
⁹ Department of Clinical Science, Danderyds Sjukhus, Karolinska Institutet, Stockholm, Sweden.
¹⁰ Intensive Care, Rigshospitalet, Copenhagen, Denmark.
¹¹ Anaesthesia and Intensive Care, Akershus University Hospital, Nordbyhagen, Norway.
¹² Anesthesiology and Intensive Care, University Hospital of North Norway, Tromsø, Norway.
¹³ Anesthesiology and Intensive Care Medicine, Hannover Medical School, Hannover, Germany.
¹⁴ Anaesthesiology and Intensive Care Medicine, Ullevål, Oslo University Hospital, Oslo, Norway.
¹⁵ Acute- and Emergency Medicine, Sykehuset Telemark, Skien, Norway.
¹⁶ Department of Cardiology, Medical Intensive Care Unit, Karolinska Institutet, Stockholm, Sweden.
¹⁷ Anaesthesia and Intensive Care, Helse Fonna, Haugesund, Norway.
¹⁸ Department of Perioperative and Intensive Care Medicine, University of Helsinki and Helsinki University Hospital, Helsinki, Finland.
¹⁹ Acute Medicine, Sykehuset Innlandet Hamar, Hamar, Norway.
²⁰ Critical Care, University Medical Center Groningen, Groningen, Netherlands.
²¹ Intensive Care Medicine, St Olavs University Hospital, Trondheim, Norway.
²² Department of Anaesthesiology, Holbaek Hospital, Holbaek, Denmark.
²³ Anaesthesia and Intensive Care, Haukeland University Hospital, Bergen, Norway.
²⁴ First Department of Anaesthesiology and Intensive Therapy, Medical University of Lublin, Lublin, Poland.
²⁵ Department of Anaesthesia and Intensive Care, Copenhagen University Hospital-Bispebjerg and Frederiksberg, Copenhagen, Denmark.
²⁶ Adult Intensive Care, The Royal Perth Hospital, Perth, Western Australia, Australia.
²⁷ Department of Intensive Care, Inselspital, Bern University Hospital and University of Bern, Bern, Switzerland.
²⁸ Intensive Care Unit, Zealand University Hospital, Køge, Denmark.
²⁹ Anaesthesia and Intensive Care, Baerum Hospital, Baerum, Norway.
³⁰ Department of Intensive Care Medicine, Inselspital, University of Bern, Bern, Switzerland.
³¹ Intensive Care, University Hospital Basel, Basel, Switzerland.
³² Anaesthesiology and Intensive Care Medicine, Landspital-The National University Hospital of Iceland, Reykjavik, Iceland.
³³ Intensive and Perioperative Care, Skane University Hospital, Malmö, Sweden.
³⁴ Intensive Care, Stavanger University Hospital, Stavanger, Norway.
³⁵ Department of Anaesthesiology and Intensive Care, Hannover Medical School, Hannover, Germany.
³⁶ Center for Intensive Care and Perioperative Medicine, Jagiellonian University Medical College, Krakow, Poland.
³⁷ Department of Anaesthesia and Intensive Care, Södersjukhuset, Karolinska Institutet, Stockholm, Sweden.
³⁸ Department of Clinical Science and Education, Södersjukhuset, Karolinska Institutet, Stockholm, Sweden.
³⁹ Department of Anaesthesia, Volda Hospital, Volda, Norway.
⁴⁰ Anaesthesia and Intensive Care, Vestfold Hospital Trust, Tønsberg, Norway.
⁴¹ Department of Anaesthesia and Intensive Care, Copenhagen University Hospital-North Zealand, Hillerød, Denmark.

PMID: 37737652
DOI: 10.1111/aas.14317

Erratum in

Correction to 'A survey of preferences for respiratory support in the intensive care unit for patients with acute hypoxaemic respiratory failure'.
[No authors listed] [No authors listed] Acta Anaesthesiol Scand. 2024 Mar;68(3):441. doi: 10.1111/aas.14385. Epub 2024 Feb 16. Acta Anaesthesiol Scand. 2024. PMID: 38362820 No abstract available.

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.

Keywords: acute hypoxaemic respiratory failure; acute respiratory distress syndrome; controlled ventilation; invasive mechanical ventilation; spontaneous ventilation; survey.

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References

REFERENCES

1. Gorman EA, O'Kane CM, McAuley DF. Acute respiratory distress syndrome in adults: diagnosis, outcomes, long-term sequelae, and management. Lancet. 2022;400:1157-1170.
1. Bellani G, Laffey JG, Pham T, et al. Epidemiology, patterns of care, and mortality for patients with acute respiratory distress syndrome in intensive care units in 50 countries. JAMA. 2016;315:788-800.
1. Claesson J, Freundlich M, Gunnarsson I, et al. Mechanical ventilation in ARDS. Acta Anaesthesiol Scand. 2015;59:286-297.
1. Fan E, Sorbo LD, Goligher EC, et al. An official American Thoracic Society/European Society of Intensive Care Medicine/Society of Critical Care Medicine clinical practice guideline: mechanical ventilation in adult patients with acute respiratory distress syndrome. Am J Respir Crit Care Med. 2017;195:1253-1263.
1. Griffiths MJD, McAuley DF, Perkins GD, et al. Guidelines on the management of acute respiratory distress syndrome. BMJ Open Respir Res. 2019;6:e000420.

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[1] Gorman EA, O'Kane CM, McAuley DF. Acute respiratory distress syndrome in adults: diagnosis, outcomes, long-term sequelae, and management. Lancet. 2022;400:1157-1170.

[2] Gorman EA, O'Kane CM, McAuley DF. Acute respiratory distress syndrome in adults: diagnosis, outcomes, long-term sequelae, and management. Lancet. 2022;400:1157-1170.

[3] Bellani G, Laffey JG, Pham T, et al. Epidemiology, patterns of care, and mortality for patients with acute respiratory distress syndrome in intensive care units in 50 countries. JAMA. 2016;315:788-800.

[4] Bellani G, Laffey JG, Pham T, et al. Epidemiology, patterns of care, and mortality for patients with acute respiratory distress syndrome in intensive care units in 50 countries. JAMA. 2016;315:788-800.

[5] Claesson J, Freundlich M, Gunnarsson I, et al. Mechanical ventilation in ARDS. Acta Anaesthesiol Scand. 2015;59:286-297.

[6] Claesson J, Freundlich M, Gunnarsson I, et al. Mechanical ventilation in ARDS. Acta Anaesthesiol Scand. 2015;59:286-297.

[7] Fan E, Sorbo LD, Goligher EC, et al. An official American Thoracic Society/European Society of Intensive Care Medicine/Society of Critical Care Medicine clinical practice guideline: mechanical ventilation in adult patients with acute respiratory distress syndrome. Am J Respir Crit Care Med. 2017;195:1253-1263.

[8] Fan E, Sorbo LD, Goligher EC, et al. An official American Thoracic Society/European Society of Intensive Care Medicine/Society of Critical Care Medicine clinical practice guideline: mechanical ventilation in adult patients with acute respiratory distress syndrome. Am J Respir Crit Care Med. 2017;195:1253-1263.

[9] Griffiths MJD, McAuley DF, Perkins GD, et al. Guidelines on the management of acute respiratory distress syndrome. BMJ Open Respir Res. 2019;6:e000420.

[10] Griffiths MJD, McAuley DF, Perkins GD, et al. Guidelines on the management of acute respiratory distress syndrome. BMJ Open Respir Res. 2019;6:e000420.

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

Collaborators

Affiliations

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

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