SACM - United States of America
Permanent URI for this collectionhttps://drepo.sdl.edu.sa/handle/20.500.14154/9668
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Item Restricted A Qualitative Interview Study of Respiratory Therapists' Perceptions and Attitudes Toward APRV in Western Saudi Arabia(Saudi Digital Library, 2025) Algurashi, Raneem; Zimmerman, Ralph ChipBackground: Airway Pressure Release Ventilation (APRV) is an advanced mechanical ventilation mode with demonstrated benefits for acute respiratory distress syndrome (ARDS), including improved oxygenation and alveolar recruitment. Despite decades of global evidence, its adoption in Western Saudi Arabia remains limited. Respiratory therapists (RTs) face challenges in its clinical application, including insufficient training, physician hesitancy, and lack of standardized protocols. Understanding RTs’ perceptions is essential to improving APRV integration and enhancing critical care practices in non-Western healthcare settings. Purpose: This study aimed to explore RTs’ perceptions and attitudes toward APRV in Western Saudi Arabia, with a focus on identifying perceived benefits and disadvantages, implementation barriers, and the influence of clinical experience and training on APRV utilization. Methods: A qualitative design using semi-structured, in-depth interviews was employed. Eight RTs from various hospitals in Western Saudi Arabia participated in virtual interviews guided by 14 open-ended questions covering demographic background, APRV perceptions, and implementation experiences. Face validity of the interview guide was established by three respiratory therapy faculty members from Georgia State University. Data were analyzed thematically using NVivo 14, following Braun and Clarke’s six-phase framework. Results: All eight RTs completed the interviews. Thematic analysis yielded 14 focused codes, which were organized into 7 sub-superordinate themes and 4 overarching superordinate themes: (1) Perceptions of APRV, (2) Barriers to Use, (3) Impact of Training and Experience, and (4) Proposed Solutions. While RTs acknowledged APRV’s benefits for oxygenation and lung protection, its use was frequently described as a last-resort strategy. Barriers included physician control over ventilator modes, lack of protocols, limited exposure, and fear of misapplication. RTs reported that confidence in using APRV improved with hands-on experience, mentorship, and simulation training. Conclusion: APRV remains underutilized in Western Saudi Arabia due to a complex interplay of institutional, educational, and experiential factors. Findings highlight the need for standardized protocols, simulation-based training, and national efforts to promote APRV literacy among both RTs and physicians. Addressing these barriers could enhance the safe and confident use of APRV in critical care.29 0Item Restricted Prevalence, And Attitudes among Respiratory Therapists in Saudi Arabia Toward Using Airway Pressure Release Ventilation Mode with Pediatric Acute Respiratory Distress Syndrome Patients(Georgia State University, 2023-03-31) Alamri, Fawaz; Zimmerman, Ralph ChipBackground: Pediatric acute respiratory distress syndrome (PARDS) significantly contributes to morbidity and mortality in young children. Children with PARDS often require intensive care admission and mechanical ventilation. Unfortunately, not much information is available to support management strategies in PARDS beyond lung protective ventilation. Examining proper mechanical ventilation techniques such as Airway Pressure Release Ventilation mode (APRV) that can support and manage these patients. Respiratory therapists' beliefs and practices of using mechanical ventilation are essential to establish guidelines for managing ventilated PARDS cases. Purpose: This study aims to evaluate the prevalence and attitude of APRV mode with PARDS patients among respiratory therapists in Saudi Arabia. Methods: The study used an online, cross-sectional survey with 22 questions administered to a convenience sample of respiratory therapists in Saudi Arabia. The survey was divided into three sections to obtain information from respondents. These sections are demographic data, the prevalence of utilizing APRV on patients with PARDS, and attitudes regarding APRV with PARDS. Results: seventy-seven responses were received from the online survey sent to respiratory therapy departments in different regions across Saudi Arabia. Three participants refused to participate, and n=20 (28,5%) of responders did not complete the survey, and their answers were excluded. Therefore, n=54 (70,1%) respondents completed the survey. The result showed that most participants have a bachelor's degree (n=43, 79,6%), master's degree (n= 8, 14,8%), associate degree (n= 2, 3.7%), and only one participant have a Ph.D. degree (n=1, 1.9). Most participants were males (n= 34, 63%). At the same time, the females were (n=20, 37%). Most of the responses were from the middle region (n=28, 51.9. The majority of respondents worked in a governmental hospital (n=52, 96.3%), while two worked in private hospitals (n=2 ,3.7%). Half of the respondents (n=27, 50%) reported that their hospital uses the APRV mechanical ventilation mode with pediatric ARDS patients. Among those who reported using APRV mode, only (n=9, 33.3%) reported following the current guidelines of the Pediatric Acute Lung Injury Consensus Conference (PALICC). In comparison, (n=6, 22.2%) reported not following the guidelines, and (n=12, 44.4%) were unsure. The findings suggest variation in the respiratory therapists' experience and confidence in using APRV. However, most participants believe it is a safe ventilation mode and can be used as both an initial and rescue mode. Conclusion: the study reveals variations in the experience and confidence of respiratory therapists in using APRV, which may influence their willingness to use it in pediatric patients with ARDS. Most participants, however, believe it is a safe ventilation mode that can be used as both an initial and rescue mode. The results of this study could inform the development of training programs and protocols designed to improve respiratory therapists' knowledge and confidence in using APRV and to promote its consistent use in pediatric patients with ARDS.25 0Item Restricted Perception and prevalence of utilizing APRV mode with Covid-19 cases among Respiratory Therapists in Saudi Arabia(2023) Alrehaili, Jihad; Goodfello, LyndaBackground: Covid-19 is a recent pandemic that spread globally. Consequently, little research focused on Covid-19 that compared different mechanical ventilator modalities that were suitable for these cases. Investigating appropriate mechanical ventilation techniques such as APRV that control the pandemic is necessary to confront any future pandemic. RTs' beliefs and practices of utilizing mechanical ventilation during the Covid-19 pandemic are essential to establish a guideline to manage ventilated Covid-19 cases. Purpose: This study aims to evaluate the perception, prevalence, and utilization of APRV mode with Covid-19 patients among respiratory therapists in Saudi Arabia. Methods: The study utilized an online, cross-sectional survey with 29 questions administered to a convenience sample of Saudi Arabian RTs. The survey was divided into three sections to obtain information from respondents. These sections are demographic data, perceptions regarding APRV and ARDS, and the prevalence of utilizing APRV on patients with Covid-19 associated ARDS. Result: Eighty-six responses were obtained from the online survey that was sent to many respiratory therapy departments in different regions across SA. Two participants refused to participate, and n=47 (54.7%) of responders did not complete the survey, and their answers were excluded. Therefore, n=37 (43%) respondents completed the survey. The majority of respondents were male n=31 (83.8%), whereas the female accounted for n=6 (16.2%) of respondents. Most of the respondents held a bachelor's degree n=32 (86.5%), while only n=5 (13.5%) held a master's degree. There were no responders who held associate or Ph.D. degrees. The result showed there was a high level of confidence among RTs that using APRV with Covid-19 cases was effective with a mean of (2.97± 0.763). Furthermore, the results showed that RTs believed that Covid-19 associated ARDS had a similar clinical picture of non-Covid-19 associated ARDS n=28 (75.7%). A Kruskal-Wallis Test revealed no significant difference in using APRV with Covid-19 cases during the pandemic between the region of practice in Saudi Arabia, Kruskal-Wallis H=3.219, p=.395. Also, the results showed that there was no significant difference among different qualifications (p=0.875). Conclusion: The overall level of perception of APRV needs to be improved, which, in turn, can improve and strengthen the management of ARDS and respiratory disorders and increase the average survival rate in Saudi Arabia. More educational sessions and classes are required for this purpose.20 0