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

Tayyba N. Aslam; Thomas L. Klitgaard; Christian A.O. Ahlstedt; Finn H. Andersen; Michelle S. Chew; Marie O. Collet; Maria Cronhjort; Stine Estrup; Ole K. Fossum; Shirin K. Frisvold; Hans Joerg Gillmann; Anders Granholm; Trine M. Gundem; Kristin Hauss; Jacob Hollenberg; Maria E. Huanca Condori; Johanna Hästbacka; Bror A. Johnstad; Eric Keus; Maj Brit N. Kjær; Pål Klepstad; Mette Krag; Reidar Kvåle; Manu L.N.G. Malbrain; Christian S. Meyhoff; Matt Morgan; Anders Møller; Carmen A. Pfortmueller; Lone M. Poulsen; Andrew C. Robertson; Joerg C. Schefold; Olav L. Schjørring; Martin Siegemund; Martin I. Sigurdsson; Fredrik Sjövall; Kristian Strand; Thomas Stueber; Wojciech Szczeklik; Rebecka R. Wahlin; Helge L. Wangberg; Karl Andre Wian; Sine Wichmann; Kristin Hofsø; Morten H. Møller; Anders Perner; Bodil S. Rasmussen; Jon H. Laake

doi:10.1111/aas.14317

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

Tayyba N. Aslam^*, Thomas L. Klitgaard, Christian A.O. Ahlstedt, Finn H. Andersen, Michelle S. Chew, Marie O. Collet, Maria Cronhjort, Stine Estrup, Ole K. Fossum, Shirin K. Frisvold, Hans Joerg Gillmann, Anders Granholm, Trine M. Gundem, Kristin Hauss, Jacob Hollenberg, Maria E. Huanca Condori, Johanna Hästbacka, Bror A. Johnstad, Eric Keus, Maj Brit N. KjærPål Klepstad, Mette Krag, Reidar Kvåle, Manu L.N.G. Malbrain, Christian S. Meyhoff, Matt Morgan, Anders Møller, Carmen A. Pfortmueller, Lone M. Poulsen, Andrew C. Robertson, Joerg C. Schefold, Olav L. Schjørring, Martin Siegemund, Martin I. Sigurdsson, Fredrik Sjövall, Kristian Strand, Thomas Stueber, Wojciech Szczeklik, Rebecka R. Wahlin, Helge L. Wangberg, Karl Andre Wian, Sine Wichmann, Kristin Hofsø, Morten H. Møller, Anders Perner, Bodil S. Rasmussen, Jon H. Laake

^*Corresponding author for this work

Research output: Contribution to journal › Journal article › Research › peer-review

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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.

Original language	English
Journal	Acta Anaesthesiologica Scandinavica
Volume	67
Issue number	10
Pages (from-to)	1383-1394
Number of pages	12
ISSN	0001-5172
DOIs	https://doi.org/10.1111/aas.14317
Publication status	Published - 2023

Bibliographical note

Funding Information:
This study was supported by the Department of Research and Development, Division of Critical Care and Emergencies, Oslo University Hospital and by South‐Eastern Norway Regional Health Authority, project number 2021061. Funders had no role in the design or conduct of this study.

Funding Information:
Anders Granholm, Maj‐Brit N. Kjær, Morten H. Møller and Anders Perner are affiliated with the Department of Intensive Care, Rigshospitalet, which receives support for research from the Novo Nordisk Foundation, Sygeforsikringen ‘danmark’, Beckett's Foundation and Pfizer and does contract research for AM‐Pharma. Anders Perner has received an honorarium from Novartis for participation in an advisory board. Bodil S. Rasmussen, Olav L. Schjørring and Thomas L. Klitgaard are affiliated with the Department of Anaesthesia and Intensive Care, Aalborg University Hospital, which receives support from the Novo Nordisk Foundation and the Ministry of Higher Education and Science. Sine Wichmann is affiliated with the Department of Anaesthesia and Intensive Care, Nordsjællands Hospital, Denmark, which has received research funding from the Novo Nordisk Foundation, Sygeforsikringen ‘danmark’, Svend Andersens' Foundation and Ehrenreich Foundation. Christian S. Meyhoff has co‐founded a start‐up company, WARD24/7 ApS, with the aim of pursuing the regulatory and commercial activities of the WARD‐project (Wireless Assessment of Respiratory and circulatory Distress, a project developing a clinical support system for continuous wireless monitoring of vital signs). WARD24/7 ApS has obtained licence agreement for any WARD‐project software and patents. One patent has been filed: ‘Wireless Assessment of Respiratory and circulatory Distress (WARD), EP 21184712.4 and EP 21205557.8’. These interests are unrelated to the current publication. Manu L. N. G. Malbrain is a professor of Critical Care Research at the First Department of Anaesthesiology and Intensive Therapy, Medical University of Lublin, Poland. He is co‐founder, past‐president and current treasurer of WSACS (The Abdominal Compartment Society, http://www.wsacs.org ). He is a member of the medical advisory Board of Pulsion Medical Systems (now fully part of Getinge group), Serenno Medical, Potrero Medical, Sentinel Medical and Baxter. He consults for BBraun, Becton Dickinson, ConvaTec, Spiegelberg, Medtronic, MedCaptain, and Holtech Medical, and received speaker's fees from PeerVoice. He holds stock options for Serenno and Potrero. He is co‐founder and president of the International Fluid Academy (IFA). The IFA ( http://www.fluidacademy.org ) is integrated within the not‐for‐profit charitable organisation iMERiT, International Medical Education and Research Initiative, under Belgian law. All other authors declare no conflicts of interest.

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

Keywords

acute hypoxaemic respiratory failure
acute respiratory distress syndrome
controlled ventilation
invasive mechanical ventilation
spontaneous ventilation
survey

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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., ... 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, 67(10), 1383-1394. https://doi.org/10.1111/aas.14317

A survey of preferences for respiratory support in the intensive care unit for patients with acute hypoxaemic respiratory failure. / 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; Kjær, Maj Brit N.; Klepstad, Pål; Krag, Mette; Kvåle, Reidar; Malbrain, Manu L.N.G.; Meyhoff, Christian S.; Morgan, Matt; Møller, Anders; Pfortmueller, Carmen A.; Poulsen, Lone M.; Robertson, Andrew C.; Schefold, Joerg C.; Schjørring, Olav L.; Siegemund, Martin; Sigurdsson, Martin I.; Sjövall, Fredrik; Strand, Kristian; Stueber, Thomas; Szczeklik, Wojciech; Wahlin, Rebecka R.; Wangberg, Helge L.; Wian, Karl Andre; Wichmann, Sine; Hofsø, Kristin; Møller, Morten H.; Perner, Anders; Rasmussen, Bodil S.; Laake, Jon H.

In: Acta Anaesthesiologica Scandinavica, Vol. 67, No. 10, 2023, p. 1383-1394.

Research output: Contribution to journal › Journal article › Research › peer-review

Aslam, TN, Klitgaard, TL, Ahlstedt, CAO, Andersen, FH, Chew, MS, Collet, MO, Cronhjort, M, Estrup, S, Fossum, OK, Frisvold, SK, Gillmann, HJ, Granholm, A, Gundem, TM, Hauss, K, Hollenberg, J, Huanca Condori, ME, Hästbacka, J, Johnstad, BA, Keus, E, Kjær, MBN, Klepstad, P, Krag, M, Kvåle, R, Malbrain, MLNG, Meyhoff, CS, Morgan, M, Møller, A, Pfortmueller, CA, Poulsen, LM, Robertson, AC, Schefold, JC, Schjørring, OL, Siegemund, M, Sigurdsson, MI, Sjövall, F, Strand, K, Stueber, T, Szczeklik, W, Wahlin, RR, Wangberg, HL, Wian, KA, Wichmann, S, Hofsø, K, Møller, MH , Perner, A, Rasmussen, BS & Laake, JH 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

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 ; Kjær, Maj Brit N. ; Klepstad, Pål ; Krag, Mette ; Kvåle, Reidar ; Malbrain, Manu L.N.G. ; Meyhoff, Christian S. ; Morgan, Matt ; Møller, Anders ; Pfortmueller, Carmen A. ; Poulsen, Lone M. ; Robertson, Andrew C. ; Schefold, Joerg C. ; Schjørring, Olav L. ; Siegemund, Martin ; Sigurdsson, Martin I. ; Sjövall, Fredrik ; Strand, Kristian ; Stueber, Thomas ; Szczeklik, Wojciech ; Wahlin, Rebecka R. ; Wangberg, Helge L. ; Wian, Karl Andre ; Wichmann, Sine ; Hofsø, Kristin ; Møller, Morten H. ; Perner, Anders ; Rasmussen, Bodil S. ; Laake, Jon H. / A survey of preferences for respiratory support in the intensive care unit for patients with acute hypoxaemic respiratory failure. In: Acta Anaesthesiologica Scandinavica. 2023 ; Vol. 67, No. 10. pp. 1383-1394.

@article{7fb77b3b811c449584198f271224ea3d,

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

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",

author = "Aslam, {Tayyba N.} and Klitgaard, {Thomas L.} and Ahlstedt, {Christian A.O.} and Andersen, {Finn H.} and Chew, {Michelle S.} and Collet, {Marie O.} and Maria Cronhjort and Stine Estrup and Fossum, {Ole K.} and Frisvold, {Shirin K.} and Gillmann, {Hans Joerg} and Anders Granholm and Gundem, {Trine M.} and Kristin Hauss and Jacob Hollenberg and {Huanca Condori}, {Maria E.} and Johanna H{\"a}stbacka and Johnstad, {Bror A.} and Eric Keus and Kj{\ae}r, {Maj Brit N.} and P{\aa}l Klepstad and Mette Krag and Reidar Kv{\aa}le and Malbrain, {Manu L.N.G.} and Meyhoff, {Christian S.} and Matt Morgan and Anders M{\o}ller and Pfortmueller, {Carmen A.} and Poulsen, {Lone M.} and Robertson, {Andrew C.} and Schefold, {Joerg C.} and Schj{\o}rring, {Olav L.} and Martin Siegemund and Sigurdsson, {Martin I.} and Fredrik Sj{\"o}vall and Kristian Strand and Thomas Stueber and Wojciech Szczeklik and Wahlin, {Rebecka R.} and Wangberg, {Helge L.} and Wian, {Karl Andre} and Sine Wichmann and Kristin Hofs{\o} and M{\o}ller, {Morten H.} and Anders Perner and Rasmussen, {Bodil S.} and Laake, {Jon H.}",

note = "Funding Information: This study was supported by the Department of Research and Development, Division of Critical Care and Emergencies, Oslo University Hospital and by South‐Eastern Norway Regional Health Authority, project number 2021061. Funders had no role in the design or conduct of this study. Funding Information: Anders Granholm, Maj‐Brit N. Kj{\ae}r, Morten H. M{\o}ller and Anders Perner are affiliated with the Department of Intensive Care, Rigshospitalet, which receives support for research from the Novo Nordisk Foundation, Sygeforsikringen {\textquoteleft}danmark{\textquoteright}, Beckett's Foundation and Pfizer and does contract research for AM‐Pharma. Anders Perner has received an honorarium from Novartis for participation in an advisory board. Bodil S. Rasmussen, Olav L. Schj{\o}rring and Thomas L. Klitgaard are affiliated with the Department of Anaesthesia and Intensive Care, Aalborg University Hospital, which receives support from the Novo Nordisk Foundation and the Ministry of Higher Education and Science. Sine Wichmann is affiliated with the Department of Anaesthesia and Intensive Care, Nordsj{\ae}llands Hospital, Denmark, which has received research funding from the Novo Nordisk Foundation, Sygeforsikringen {\textquoteleft}danmark{\textquoteright}, Svend Andersens' Foundation and Ehrenreich Foundation. Christian S. Meyhoff has co‐founded a start‐up company, WARD24/7 ApS, with the aim of pursuing the regulatory and commercial activities of the WARD‐project (Wireless Assessment of Respiratory and circulatory Distress, a project developing a clinical support system for continuous wireless monitoring of vital signs). WARD24/7 ApS has obtained licence agreement for any WARD‐project software and patents. One patent has been filed: {\textquoteleft}Wireless Assessment of Respiratory and circulatory Distress (WARD), EP 21184712.4 and EP 21205557.8{\textquoteright}. These interests are unrelated to the current publication. Manu L. N. G. Malbrain is a professor of Critical Care Research at the First Department of Anaesthesiology and Intensive Therapy, Medical University of Lublin, Poland. He is co‐founder, past‐president and current treasurer of WSACS (The Abdominal Compartment Society, http://www.wsacs.org ). He is a member of the medical advisory Board of Pulsion Medical Systems (now fully part of Getinge group), Serenno Medical, Potrero Medical, Sentinel Medical and Baxter. He consults for BBraun, Becton Dickinson, ConvaTec, Spiegelberg, Medtronic, MedCaptain, and Holtech Medical, and received speaker's fees from PeerVoice. He holds stock options for Serenno and Potrero. He is co‐founder and president of the International Fluid Academy (IFA). The IFA ( http://www.fluidacademy.org ) is integrated within the not‐for‐profit charitable organisation iMERiT, International Medical Education and Research Initiative, under Belgian law. All other authors declare no conflicts of interest. Publisher Copyright: {\textcopyright} 2023 The Authors. Acta Anaesthesiologica Scandinavica published by John Wiley & Sons Ltd on behalf of Acta Anaesthesiologica Scandinavica Foundation.",

year = "2023",

doi = "10.1111/aas.14317",

language = "English",

volume = "67",

pages = "1383--1394",

journal = "Acta Anaesthesiologica Scandinavica",

issn = "0001-5172",

publisher = "Wiley-Blackwell",

number = "10",

}

TY - JOUR

T1 - A survey of preferences for respiratory support in the intensive care unit for patients with acute hypoxaemic respiratory failure

AU - Aslam, Tayyba N.

AU - Klitgaard, Thomas L.

AU - Ahlstedt, Christian A.O.

AU - Andersen, Finn H.

AU - Chew, Michelle S.

AU - Collet, Marie O.

AU - Cronhjort, Maria

AU - Estrup, Stine

AU - Fossum, Ole K.

AU - Frisvold, Shirin K.

AU - Gillmann, Hans Joerg

AU - Granholm, Anders

AU - Gundem, Trine M.

AU - Hauss, Kristin

AU - Hollenberg, Jacob

AU - Huanca Condori, Maria E.

AU - Hästbacka, Johanna

AU - Johnstad, Bror A.

AU - Keus, Eric

AU - Kjær, Maj Brit N.

AU - Klepstad, Pål

AU - Krag, Mette

AU - Kvåle, Reidar

AU - Malbrain, Manu L.N.G.

AU - Meyhoff, Christian S.

AU - Morgan, Matt

AU - Møller, Anders

AU - Pfortmueller, Carmen A.

AU - Poulsen, Lone M.

AU - Robertson, Andrew C.

AU - Schefold, Joerg C.

AU - Schjørring, Olav L.

AU - Siegemund, Martin

AU - Sigurdsson, Martin I.

AU - Sjövall, Fredrik

AU - Strand, Kristian

AU - Stueber, Thomas

AU - Szczeklik, Wojciech

AU - Wahlin, Rebecka R.

AU - Wangberg, Helge L.

AU - Wian, Karl Andre

AU - Wichmann, Sine

AU - Hofsø, Kristin

AU - Møller, Morten H.

AU - Perner, Anders

AU - Rasmussen, Bodil S.

AU - Laake, Jon H.

N1 - Funding Information: This study was supported by the Department of Research and Development, Division of Critical Care and Emergencies, Oslo University Hospital and by South‐Eastern Norway Regional Health Authority, project number 2021061. Funders had no role in the design or conduct of this study. Funding Information: Anders Granholm, Maj‐Brit N. Kjær, Morten H. Møller and Anders Perner are affiliated with the Department of Intensive Care, Rigshospitalet, which receives support for research from the Novo Nordisk Foundation, Sygeforsikringen ‘danmark’, Beckett's Foundation and Pfizer and does contract research for AM‐Pharma. Anders Perner has received an honorarium from Novartis for participation in an advisory board. Bodil S. Rasmussen, Olav L. Schjørring and Thomas L. Klitgaard are affiliated with the Department of Anaesthesia and Intensive Care, Aalborg University Hospital, which receives support from the Novo Nordisk Foundation and the Ministry of Higher Education and Science. Sine Wichmann is affiliated with the Department of Anaesthesia and Intensive Care, Nordsjællands Hospital, Denmark, which has received research funding from the Novo Nordisk Foundation, Sygeforsikringen ‘danmark’, Svend Andersens' Foundation and Ehrenreich Foundation. Christian S. Meyhoff has co‐founded a start‐up company, WARD24/7 ApS, with the aim of pursuing the regulatory and commercial activities of the WARD‐project (Wireless Assessment of Respiratory and circulatory Distress, a project developing a clinical support system for continuous wireless monitoring of vital signs). WARD24/7 ApS has obtained licence agreement for any WARD‐project software and patents. One patent has been filed: ‘Wireless Assessment of Respiratory and circulatory Distress (WARD), EP 21184712.4 and EP 21205557.8’. These interests are unrelated to the current publication. Manu L. N. G. Malbrain is a professor of Critical Care Research at the First Department of Anaesthesiology and Intensive Therapy, Medical University of Lublin, Poland. He is co‐founder, past‐president and current treasurer of WSACS (The Abdominal Compartment Society, http://www.wsacs.org ). He is a member of the medical advisory Board of Pulsion Medical Systems (now fully part of Getinge group), Serenno Medical, Potrero Medical, Sentinel Medical and Baxter. He consults for BBraun, Becton Dickinson, ConvaTec, Spiegelberg, Medtronic, MedCaptain, and Holtech Medical, and received speaker's fees from PeerVoice. He holds stock options for Serenno and Potrero. He is co‐founder and president of the International Fluid Academy (IFA). The IFA ( http://www.fluidacademy.org ) is integrated within the not‐for‐profit charitable organisation iMERiT, International Medical Education and Research Initiative, under Belgian law. All other authors declare no conflicts of interest. Publisher Copyright: © 2023 The Authors. Acta Anaesthesiologica Scandinavica published by John Wiley & Sons Ltd on behalf of Acta Anaesthesiologica Scandinavica Foundation.

PY - 2023

Y1 - 2023

N2 - 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.

AB - 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.

KW - acute hypoxaemic respiratory failure

KW - acute respiratory distress syndrome

KW - controlled ventilation

KW - invasive mechanical ventilation

KW - spontaneous ventilation

KW - survey

U2 - 10.1111/aas.14317

DO - 10.1111/aas.14317

M3 - Journal article

C2 - 37737652

AN - SCOPUS:85171846745

VL - 67

SP - 1383

EP - 1394

JO - Acta Anaesthesiologica Scandinavica

JF - Acta Anaesthesiologica Scandinavica

SN - 0001-5172

IS - 10

ER -