Some notes on reporting ventilation studies

Research output: Contribution to journalArticle

Abstract

I was looking through the February 2019 issue of the journal in preparation for an exam I was sitting later that week. The primary focus of that exam was respiratory physiology, so to my great joy I found that several articles in that issue pertained to ventilation. While reading through these articles (it is not my aim to single these out, nor have I analysed how widespread these issues are), I noticed two things that were commonly omitted in these study reports: the ventilators used, as well as the patterns and modes of ventilation that were utilised.
Ventilators are machines that deliver a treatment, but since we record a variety of variables they are also utilised as physiological measurement equipment. Moreover, in studies pertaining to mechanical ventilation, ventilators are the central piece of equipment that is being utilised. As such, it seems to me odd not to state what ventilators were utilised. Ventilators differ by more than their outer look and interface set-up. They might utilise different sensors to perform measurements and might utilise different algorithms in their modes.
The second point concerns the patterns and modes of ventilation used. Now while it could be assumed that volume targeting patterns were used due to references made to the acute respiratory distress syndrome protocol, it is unclear whether volume control or pressure regulated volume control was used. While similar comments could be made about the modes utilised, the choice of patterns is of particular significance especially when evaluating the effect of the delivered volumes on the recorded pressure variables.
If we looked at a study concerning blood gases, we would expect to know the type of analyser utilised. If we looked at a cardiopulmonary exercise testing study, we would want to know the set-up of the study: the equipment used, the protocol utilised, and the software employed. Similarly, if we looked at a pulmonary physiology study or a pharmacology study, we would expect to have information regarding the key elements of these studies: the physiological measurement system or the pharmacological agent used (including their manufacturers). The situation should not be any different in ventilation studies. If we are to be able to compare studies to each other, we need to have the details to be able to do this. Of course, when conducting multicentre studies, there might be a difference in the equipment utilised. This is not ideal, but it is the reality of clinical work and should simply be acknowledged. It is likely that in many cases it would not matter which ventilator was utilised (though patterns of ventilation might be of greater significance here), but perhaps in some situations a discrepancy will be noticed. Nevertheless, I think it would be within the bounds of standard scientific practice to declare these, and as such I encourage authors, reviewers, and editors to keep this consideration in mind.
Original languageEnglish
Pages (from-to)NP25
Number of pages1
JournalJournal of the Intensive Care Society
Volume20
Issue number3
Early online date17 Jun 2019
DOIs
Publication statusPublished - Aug 2019

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