Assessment of the Knowledge, Perception, and Prevalence of Using APRV Among Respiratory Therapists

Abstract

Background: ARDS is a most serious and fatal disease in ICUs throughout the world with high mortality rates. Airway pressure release ventilation (APRV) shows significant outcomes when used with ARDS patients resulting in mortality reduction. There are no studies test the knowledge and perception regarding APRV and ARDS besides the APRV prevalence in Saudi Arabia (SA). This study aimed to survey RTs to assess their knowledge and perception of using APRV on patients with ARDS, and to explore the prevalence of using APRV mode in the Eastern Province (EP) of SA. We hypothesized that not many RTs in SA have the knowledge to effectively utilize the APRV mode on ARDS patients.

Methods: A cross-sectional study was designed as a self-administered survey based on current literature and research. The population of this study was a non-probability convenience sample. Participants were limited to RTs only. An online link was sent to 116 RTs from 6 hospitals, divided equally into 3 government and 3 private hospitals. After collecting the data, statistical analysis, including the Chi-Square test and the Fisher Exact test were computed to examine differences in APRV knowledge and perceptions between the two types of hospitals. This study was approved by the Georgia State University Institutional Review Board.

Results: A total of 52 returned surveys were received with a response rate of 44.8%. The majority of participants were bachelor’s degree holders (90.2%) who had less than 8 years of experience (78%). RTs had a general level of knowledge about ARDS and APRV mode (63%). Most hospitals in the EP use the APRV mode (96%) and used by more than 80% of the respondents, half of whom had positive outcomes. Patients with ARDS were the most common disease when APRV was applied (98%). Few significant differences were found between the two types of hospital therapists in terms of APRV usage (P = 0.0002 and P = 0.006). However, aspects like APRV-ARDS knowledge, perception, and ARDS protocol and practices showed no significant differences between participants in the two groups.

Conclusions: The vast majority of EP hospitals used ventilators with the APRV mode and most of their therapists have used the mode. This study identified a gap in literature which revealed limited data involving RTs knowledge and perceptions with APRV used as a treatment for ARDS. Further studies on RTs, involving APRV and ARDS in SA are needed with larger sample size and to include multiple regions of the country.