| Title: |
Uncertainty and decision-making in Critical Care: lessons from managing COVID-19 ARDS for the next pandemic |
| Authors: |
Matsumoto, Kenki; Prowle, John; Puthucheary, Zudin; Cecconi, Maurizio; Fazzini, Brigitta; Malcolm, Hannah; Nydahl, Peter; Osman, Magda; Santini, Alessandro; Schaller, Stefan; Thomson, William; Berk, Danielle van den; de Poll, Marcel van; Stephens, Timothy |
| Publisher Information: |
Springer Science and Business Media LLC |
| Publication Year: |
2024 |
| Description: |
Purpose COVID-19 ARDS was an emergent syndrome that led to high volumes of critically ill ventilated patients. We explored influences on decision-making regarding management of COVID-19 ARDS mechanical ventilation to identify modifiable factors to improve preparedness for future pandemics. Methods A systematic review of existing literature and small group interviews informed the development of an international questionnaire (UK, Italy, Germany and Netherlands) on factors influencing COVID-19 ARDS ventilation decision-making in critical care professionals. Participants were asked to rank four high-level themes in order of importance: disease (uncertainties around COVID-19 ARDS), contextual (cognitive strain), environmental (structural logistics) and team factors. Participants also ranked the subthemes within each theme. Thematic analysis was used to derive findings from qualitative data. Kruskal-Wallis, Mann-Whitney U and Kendall’s Tau were used for quantitative data analysis. Results Patient factors (co-morbidities, clinical and biochemical parameters) were the most heavily studied influences in the literature on decision-making regarding organ support, whereas uncertainty was one of the least explored subthemes. In total, 371 critical care professionals from 4 professional groups in 4 countries responded to the questionnaire. Disease uncertainty (lack of applicable guidelines and unfamiliarity with pathophysiology) was ranked as the most important influence on ventilation decision-making for COVID-19 ARDS across regions, professions and experience levels. This was followed by team, then contextual, then environmental factors (p |
| Document Type: |
other/unknown material |
| Language: |
unknown |
| DOI: |
10.21203/rs.3.rs-4004154/v1 |
| Availability: |
https://doi.org/10.21203/rs.3.rs-4004154/v1; https://www.researchsquare.com/article/rs-4004154/v1; https://www.researchsquare.com/article/rs-4004154/v1.html |
| Rights: |
https://creativecommons.org/licenses/by/4.0/ |
| Accession Number: |
edsbas.EC52E4FF |
| Database: |
BASE |