Noninvasive Ventilation Utilization in the Kingdom of Saudi Arabia: Results of a National Survey

Overview

Journal Ann Thorac Med

Specialty Pulmonary Medicine

Date 2018 Nov 13

PMID 30416596

Citations 1

Authors

Mohammed Dhafer AlAhmari

Hajed Al-Otaibi

Hatem Qutub

Ibrahim Albalawi

Abdullah Alqahtani

Bandar Almasoudi

Affiliations

Soon will be listed here.

Abstract

Introduction: Noninvasive ventilation (NIV) has been extensively used globally and is often administered as the first-line treatment. Currently, data regarding the utilization of NIV in the Kingdom of Saudi Arabia (KSA) is scarce. The present study aimed to assess and quantify the utilization of NIV in clinical practice across the KSA and investigate obstacles that may cause NIV underutilization.

Methods: A web-based survey composed of a 31-item, self-administered questionnaire was developed and validated. The questionnaire was designed to obtain general information about each hospital, availability of NIV practice, use of NIV, and obstacles that can hinder NIV use in clinical settings; the survey was sent to senior respiratory therapists (RTs) of 76 hospitals. Descriptive statistics were used to analyze the data.

Results: Sixty-one hospitals (80.3%) responded to the survey (47 governmental and 14 private). NIV was available in all hospitals and all the Intensive Care Units. The majority of RTs (85%) reported having a good experience with NIV, with a confidence rate of 60%; however, only 22% of the RTs had received formal training. Although NIV setup was the sole responsibility of RTs, only 69% participated in NIV management. Moreover, 72% of hospitals had an NIV setup protocol in place. However, 50% of them lacked a protocol for NIV failure. NIV protocols for specific indications were present in 64% of the hospitals: 47.2% for monitoring and 42% for weaning. The perceived efficiency of NIV practice was low in the medical wards, with a <49% success rate in 39% of the hospitals. Shortage of staff and lack of formal training were the most common reasons for NIV underutilization.

Conclusion: The efficiency of NIV in the KSA was low. The RTs expressed moderate confidence in administering NIV. Lack of appropriate exposure and formal training could have negative impacts on NIV practice.

Citing Articles

Assessing respiratory therapists' compliance with cystic fibrosis guidelines in Saudi Arabia: A descriptive quantitative study.

Hakeem J, Turkestani F, Alqahtani M, Al Nufaiei Z, Al Zhranei R, Alhadian F Can J Respir Ther. 2025; 61:20-32.

PMID: 40078596 PMC: 11901341. DOI: 10.29390/001c.129988.

The Impact of BiLevel Positive Airway Pressure (BiPAP) Application Timing on Emergency Room Length of Stay in Patients With Pulmonary Edema: A Single-Center, Retrospective Cohort Study.

Khayat S, Ali M, Almasoudi L, Fatani A, Albarnawi W, Bsooki M Cureus. 2023; 14(12):e33193.

PMID: 36601212 PMC: 9806280. DOI: 10.7759/cureus.33193.

References

Bierer G, Soo Hoo G . Noninvasive ventilation for acute respiratory failure: a national survey of Veterans Affairs hospitals. Respir Care. 2009; 54(10):1313-20. View

Sharma S, Agarwal R, Aggarwal A, Gupta D, Jindal S . A survey of noninvasive ventilation practices in a respiratory ICU of North India. Respir Care. 2012; 57(7):1145-53. DOI: 10.4187/respcare.01541. View

Hess D, Pang J, Camargo Jr C . A survey of the use of noninvasive ventilation in academic emergency departments in the United States. Respir Care. 2009; 54(10):1306-12. View

Antonelli M, Conti G, Bufi M, Costa M, Lappa A, Rocco M . Noninvasive ventilation for treatment of acute respiratory failure in patients undergoing solid organ transplantation: a randomized trial. JAMA. 2000; 283(2):235-41. DOI: 10.1001/jama.283.2.235. View

Crimi C, Noto A, Princi P, Esquinas A, Nava S . A European survey of noninvasive ventilation practices. Eur Respir J. 2010; 36(2):362-9. DOI: 10.1183/09031936.00123509. View

Kramer N, Meyer T, Meharg J, Cece R, Hill N . Randomized, prospective trial of noninvasive positive pressure ventilation in acute respiratory failure. Am J Respir Crit Care Med. 1995; 151(6):1799-806. DOI: 10.1164/ajrccm.151.6.7767523. View

Brochard L, Mancebo J, Wysocki M, Lofaso F, Conti G, Rauss A . Noninvasive ventilation for acute exacerbations of chronic obstructive pulmonary disease. N Engl J Med. 1995; 333(13):817-22. DOI: 10.1056/NEJM199509283331301. View

Demoule A, Girou E, Richard J, Taille S, Brochard L . Increased use of noninvasive ventilation in French intensive care units. Intensive Care Med. 2006; 32(11):1747-55. DOI: 10.1007/s00134-006-0229-z. View

Ozsancak Ugurlu A, Sidhom S, Khodabandeh A, Ieong M, Mohr C, Lin D . Use and outcomes of noninvasive positive pressure ventilation in acute care hospitals in Massachusetts. Chest. 2014; 145(5):964-971. DOI: 10.1378/chest.13-1707. View

10.

Esteban A, Ferguson N, Meade M, Frutos-Vivar F, Apezteguia C, Brochard L . Evolution of mechanical ventilation in response to clinical research. Am J Respir Crit Care Med. 2007; 177(2):170-7. DOI: 10.1164/rccm.200706-893OC. View

11.

Kaul S, Pearson M, Coutts I, Lowe D, Roberts M . Non-invasive ventilation (NIV) in the clinical management of acute COPD in 233 UK hospitals: results from the RCP/BTS 2003 National COPD Audit. COPD. 2009; 6(3):171-6. DOI: 10.1080/15412550902902646. View

12.

Fiorino S, Bacchi-Reggiani L, Detotto E, Battilana M, Borghi E, Denitto C . Efficacy of non-invasive mechanical ventilation in the general ward in patients with chronic obstructive pulmonary disease admitted for hypercapnic acute respiratory failure and pH < 7.35: a feasibility pilot study. Intern Med J. 2015; 45(5):527-37. DOI: 10.1111/imj.12726. View

13.

Alyami M, AlAhmari M, Alotaibi H, AlRabeeah S, Albalawi I, Mubasher M . Evaluation of efficacy of non-invasive ventilation in Non-COPD and non-trauma patients with acute hypoxemic respiratory failure: A systematic review and meta-analysis. Ann Thorac Med. 2015; 10(1):16-24. PMC: 4286839. DOI: 10.4103/1817-1737.146855. View

14.

Maheshwari V, Paioli D, Rothaar R, Hill N . Utilization of noninvasive ventilation in acute care hospitals: a regional survey. Chest. 2006; 129(5):1226-33. DOI: 10.1378/chest.129.5.1226. View

15.

Plant P, Owen J, Elliott M . Early use of non-invasive ventilation for acute exacerbations of chronic obstructive pulmonary disease on general respiratory wards: a multicentre randomised controlled trial. Lancet. 2000; 355(9219):1931-5. DOI: 10.1016/s0140-6736(00)02323-0. View

16.

Hill N . Where should noninvasive ventilation be delivered?. Respir Care. 2008; 54(1):62-70. View

17.

Lightowler J, Wedzicha J, Elliott M, Ram F . Non-invasive positive pressure ventilation to treat respiratory failure resulting from exacerbations of chronic obstructive pulmonary disease: Cochrane systematic review and meta-analysis. BMJ. 2003; 326(7382):185. PMC: 140272. DOI: 10.1136/bmj.326.7382.185. View

18.

Carlucci A, Richard J, Wysocki M, Lepage E, Brochard L . Noninvasive versus conventional mechanical ventilation. An epidemiologic survey. Am J Respir Crit Care Med. 2001; 163(4):874-80. DOI: 10.1164/ajrccm.163.4.2006027. View

19.

Bott J, Carroll M, Conway J, Keilty S, Ward E, Brown A . Randomised controlled trial of nasal ventilation in acute ventilatory failure due to chronic obstructive airways disease. Lancet. 1993; 341(8860):1555-7. DOI: 10.1016/0140-6736(93)90696-e. View

20.

Domenighetti G, Gayer R, Gentilini R . Noninvasive pressure support ventilation in non-COPD patients with acute cardiogenic pulmonary edema and severe community-acquired pneumonia: acute effects and outcome. Intensive Care Med. 2002; 28(9):1226-32. DOI: 10.1007/s00134-002-1373-8. View