Preferences for mechanical ventilation modes among intensivists in Türkiye: a nationwide point-prevalence study

TL;DR

This study surveyed mechanical ventilation preferences in Turkish ICUs and found conventional modes like SIMV are most commonly used.

Contribution

The study provides a nationwide snapshot of ventilation mode preferences and outcomes in Turkish ICUs without causal analysis.

Findings

Conventional modes were used in 84.5% of patients, with SIMV being the most common.

Adaptive and biphasic modes were used in 10.6% and 4.9% of cases, respectively.

43.4% of patients died during their ICU stay, and outcomes like weaning and tracheostomy were reported descriptively.

Abstract

Invasive mechanical ventilation (IMV) is a fundamental intervention for patients with respiratory failure in intensive care units (ICUs). This nationwide, multicenter point-prevalence study aimed to describe current mechanical ventilation mode preferences (conventional, adaptive, and biphasic) in Turkish ICUs and to report associated clinical outcomes descriptively, without assessing causal relationships.

A nationwide, multicenter point-prevalence study was conducted on 17 April 2024 and included adult patients (≥18 years) who had been receiving IMV for more than 24 h. Data on patient demographics, ventilation mode distribution, ventilatory parameters, and descriptive clinical outcomes on day 28 (weaning status, tracheostomy, and mortality) were recorded without comparative outcome analysis.

A total of 426 patients were included. Conventional modes were used in 84.5% of patients, adaptive modes in 10.6%, and biphasic modes in 4.9%. Synchronized intermittent mandatory ventilation (SIMV) was the most commonly used conventional mode. The primary indication for IMV was acute respiratory failure (61%), with pneumonia being the leading cause. Among the 350 orotracheally intubated patients, 25.6% were in the weaning phase on the study day. A total of 59 (16.9%) patients were extubated, 150 (42.9%) underwent tracheostomy, and 64 (18.2%) remained intubated on day 28. Overall, 185 (43.4%) patients died during their ICU stay, 152 (35.7%) remained in the ICU, and 89 (20.9%) were successfully discharged from the ICU.

Conventional ventilation modes, particularly SIMV, were more commonly used in Turkish intensive care units (ICUs), whereas adaptive modes were less frequently applied. These patterns may reflect factors such as clinician familiarity, institutional practices, and equipment availability rather than definitive preferences. Although the impact of ventilation modes on clinical outcomes was not comparatively evaluated in this study, the choice of ventilation mode may still influence patient outcomes. Therefore, further prospective and comparative studies are warranted to better elucidate this relationship.

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