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. 2024 Jun 28;69(7):773-781.
doi: 10.4187/respcare.11677.

Survey of Ventilator Waveform Interpretation Among ICU Professionals

Ping Liu  1 , Shan Lyu  2 , Eduardo Mireles-Cabodevila  3 , Andrew G Miller  4 , Fai A Albuainain  5 , Miguel Ibarra-Estrada  6 , Jie Li  7
Affiliations

Survey of Ventilator Waveform Interpretation Among ICU Professionals

Ping Liu et al. Respir Care. .

Abstract

Background: The interpretation of ventilator waveforms is essential for effective and safe mechanical ventilation but requires specialized training and expertise. This study aimed to investigate the ability of ICU professionals to interpret ventilator waveforms, identify areas requiring further education and training, and explore the factors influencing their interpretation skills.

Methods: We conducted an international online anonymous survey of ICU professionals (physicians, nurses, and respiratory therapists [RTs]), with ≥ 1 y of experience working in the ICU. The survey consisted of demographic information and 15 multiple-choice questions related to ventilator waveforms. Results were compared between professions using descriptive statistics, and logistic regression (expressed as odds ratios [ORs; 95% CI]) was performed to identify factors associated with high performance, which was defined by a threshold of 60% correct answers.

Results: A total of 1,832 professionals from 31 countries or regions completed the survey; 53% of respondents answered ≥ 60% of the questions correctly. The 3 questions with the most correct responses were related to waveforms that demonstrated condensation (90%), pressure overshoot (79%), and bronchospasm (75%). Conversely, the 3 questions with the fewest correct responses were waveforms that demonstrated early cycle leading to double trigger (43%), severe under assistance (flow starvation) (37%), and early/reverse trigger (31%). Factors significantly associated with ≥ 60% correct answers included years of ICU working experience (≥ 10 y, OR 1.6 [1.2-2.0], P < .001), profession (RT, OR 2.8 [2.1-3.7], P < .001), highest degree earned (graduate, OR 1.7 [1.3-2.2], P < .001), workplace (teaching hospital, OR 1.4 [1.1-1.7], P = .008), and prior ventilator waveforms training (OR 1.7 [1.3-2.2], P < .001).

Conclusions: Slightly over half respondents correctly identified ≥ 60% of waveforms demonstrating patient-ventilator discordance. High performance was associated with ≥ 10 years of ICU working experience, RT profession, graduate degree, working in a teaching hospital, and prior ventilator waveforms training. Some discordances were poorly recognized across all groups of surveyed professionals.

Keywords: ICUs; mechanical ventilation; patient-ventilator discordance; ventilator; waveform interpretation.

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Conflict of interest statement

Dr Li discloses relationships with Fisher & Paykel Healthcare, Aerogen, Vincent Medical, the Rice Foundation, the American Association for Respiratory Care, Vincent, and Heyer. Dr Li is a section editor for Respiratory Care. Mr Miller discloses relationships with Saxe Communications, S2N Health, and Fisher & Paykel. Mr Miller is a section editor for Respiratory Care. Dr Mireles-Cabodevila is a co-owner of a patent for mid-frequency ventilation. Dr Mireles-Cabodevila discloses relationships with IngMar Medical and Elsevier. The remaining authors have disclosed no conflicts of interest.

Figures

Fig. 1.
Fig. 1.
The percentage of questions answered correctly by the respondents. The x axis represents the number of questions answered correctly by the respondents, ranging from 0–15. The y axis represents the proportion of respondents of the total number. Among all respondents, 2% answered all 15 questions correctly, while 2% did not answer any questions correctly. The remaining respondents fall within different ranges of correct answers, forming a distribution across the x axis.
Fig. 2.
Fig. 2.
The accuracy rate by the respondents from different professions. RT = respiratory therapist.
Fig. 3.
Fig. 3.
Proportion of respondents who chose “I don’t know” RT = respiratory therapist.
See this image and copyright information in PMC

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References

    1. Mireles-Cabodevila E, Siuba MT, Chatburn RL. A taxonomy for patient-ventilator interactions and a method to read ventilator waveforms. Respir Care 2022;67(1):129-148. - PubMed
    1. Chao DC, Scheinhorn DJ, Stearn-Hassenpflug M. Patient-ventilator trigger asynchrony in prolonged mechanical ventilation. Chest 1997;112(6):1592-1599. - PubMed
    1. Thille AW, Rodriguez P, Cabello B, Lellouche F, Brochard L. Patient-ventilator asynchrony during assisted mechanical ventilation. Intensive Care Med 2006;32(10):1515-1522. - PubMed
    1. de Wit M, Pedram S, Best AM, Epstein SK. Observational study of patient-ventilator asynchrony and relationship to sedation level. J Crit Care 2009;24(1):74-80. - PMC - PubMed
    1. Colombo D, Cammarota G, Alemani M, Carenzo L, Barra FL, Vaschetto R, et al. Efficacy of ventilator waveforms observation in detecting patient-ventilator asynchrony. Crit Care Med 2011;39(11):2452-2457. - PubMed

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