Mechanical Ventilation Discontinuation Practices in Asia: A Multinational Survey

Area of Science:

• Critical Care Medicine
• Pulmonary Medicine
• Respiratory Care

Background:

• Limited data exists on mechanical ventilation discontinuation practices in Asia.
• Understanding current practices is crucial for improving patient outcomes in intensive care units (ICUs).

Purpose of the Study:

• To document self-reported mechanical ventilation discontinuation practices among Asian Intensive Care specialists.
• To determine clinical equipoise regarding protocolized weaning in this population.

Main Methods:

• A survey using a validated questionnaire was distributed to Asian Intensive Care specialists via a snowball method.
• Data from 2,074 respondents across 20 territories were analyzed using modified Poisson regression.

Main Results:

• A significant portion of specialists (42%) worked in ICUs with respiratory therapists.
• Practices varied, with 78.9% using spontaneous breathing trials initially, and diverse approaches to pressure support and synchronized intermittent mandatory ventilation.
• While 61.8% worked in ICUs with weaning protocols, adherence varied, and clinical equipoise was observed regarding protocolized weaning benefits.

Conclusions:

• A substantial minority of Asian Intensive Care specialists deviate from best evidence and current guidelines for mechanical ventilation weaning.
• Heterogeneity in practices and beliefs suggests ongoing debate and potential for improvement in protocolized weaning implementation.