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 clinicians to interpret ventilator waveforms, identify areas requiring further education and training, and explore the factors influencing their interpretation skills.
Methods: An international online anonymous survey was conducted upon approval by the Institutional Review Board. ICU clinicians (physicians, nurses, and respiratory therapists) with at least one year of experience were invited to participate. 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 [OR, 95% confidence interval]) was performed to identify factors associated with >60% correct answers.
Results: 2,067 ICU clinicians from 31 countries participated, yielding 1,832 valid questionnaires with responses to all 15 waveform questions. 53% of respondents answered at least 60% of the questions correctly. The three questions with the highest correct responses were condensation (90%), pressure overshot (79%), and bronchospasm (75%). Conversely, the three questions with the lowest correct responses were early cycle with double trigger (43%), patient inspiratory effort (37%), and early (reverse) trigger (31%). Comparison across professions is included in Figure 1. Factors significantly associated with >60% correct answers included years of working experience (≥ 10 years, OR = 1.1.554 [1.218-1.983], P < .001), profession (respiratory therapist, OR = 2.814 [2.142-3.697], P < .001), highest degree earned (graduate, OR = 1.705 [1.326-2.192], P < .001), workplace (teaching hospital, OR = 1.376 [1.085-1.744], P = .008), and mechanical ventilation training (OR = 1.698 [1.299-2.219], P < .001) (see Table 1).
Conclusions: Slightly over half respondents correctly identified at least 60% of waveform questions. Years of working experience, profession, highest degree earned, workplace, and mechanical ventilation training were significantly associated with improved interpretation skills. To enhance clinicians’ ability to interpret ventilator waveform, targeted education and training programs should be implemented.
Figure 1. Percentages of participants who answered correctly
Footnotes
Commercial Relationships: Dr. Li discloses relationships with Fisher & Paykel Healthcare, Aerogen, the Rice Foundation, the American Association for Respiratory Care, and Heyer. Dr. Li and Mr. Miller are section editors for RESPIRATORY CARE. Mr. Miller discloses relationships with Saxe Communications, S2N Health, and Fisher and Paykel. Dr. Mireles-Cabodevila is a co-owner of a patent for mid-frequency ventilation. He discloses relationships with IngMar Medical and Elsevier publishers. Other authors do not have any conflicts of interest to disclose.
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