• 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 Kjaer, Pål Klepstad, Mette Krag, Reidar Kvåle, MalbrainManu L N GMLNG0000-0002-1816-5255First Department of Anaesthesiology and Intensive Therapy, Medical University of Lublin, Lublin, Poland., 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, and SVALBARD investigators.
• Department of Anaesthesiology and Intensive Care Medicine, Division of Emergencies and Critical Care, Rikshopitalet, Oslo University Hospital, Oslo, Norway.
• Acta Anaesthesiol Scand. 2023 Nov 1; 67 (10): 138313941383-1394.

BackgroundWhen 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.MethodsWe 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.ResultsThe 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.ConclusionsThe 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.© 2023 The Authors. Acta Anaesthesiologica Scandinavica published by John Wiley & Sons Ltd on behalf of Acta Anaesthesiologica Scandinavica Foundation.

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