A Cross-National Examination of Weaning Parameter Usage: Comparing Respiratory Therapists’ Perceptions in Saudi Arabia and the United States

Abstract

Background: Weaning from mechanical ventilation is a critical goal following patient intubation in intensive care settings. Effective weaning from mechanical ventilation is essential for reducing morbidity and mortality among ICU patients. Weaning parameters play a significant role in determining the success of the weaning process. However, their usage differs across healthcare settings. Purpose: This study aims to compare the perceptions of respiratory therapists in Saudi Arabia and the United States regarding the frequency of use and the prioritization of various mechanical ventilation weaning parameters in intensive care units, as well as how patient-specific factors are considered in the weaning process. Methods: A cross-sectional study was conducted using an online survey distributed to RTs in both countries. The survey included demographic questions and questions to evaluate the perceived frequency of use of weaning parameters and the influence of patient-specific factors on the success of weaning from mechanical ventilation. Descriptive statistics, independent samples t-tests, and effect size calculations were conducted to analyze the data. Results: A total of 99 respiratory therapists participated in the survey (Saudi Arabia: n=63; United States: n=36). The study findings revealed that among patient-specific factors, only age showed a statistically significant difference between countries, with a higher mean rating in Saudi Arabia (M = 3.27, SD = 1.12) compared to the United States (M = 2.53, SD = 1.50), p = .006. Furthermore, regarding the perceived frequency of use of 18 various weaning parameters, only the Glasgow Coma Scale (GCS) showed a statistically significant difference between countries, with higher perceived importance among Saudi RTs (M = 13.98, SD = 4.59) compared to U.S. RTs (M = 7.67, SD = 5.47), p < .001. Moreover, the most frequently used parameters rated by RTs in Saudi Arabia are Glasgow Coma Scale (GCS), SBT trials, pH, respiratory rate (RR), and partial pressure of carbon dioxide (PCO2). On the other hand, the five most commonly used parameters in the United States are SBT trials, PCO2, following commands, pH, and minute ventilation (VE). Conclusion: Overall, only a few significant differences were observed, which indicates consistency in the perceived use of weaning parameters between Saudi Arabia and the United States, suggesting a shared foundation in clinical practice. These insights may serve as a reference for other countries aiming to evaluate or systematize their weaning strategies and could also inform educational programs for respiratory therapy students by highlighting the key parameters emphasized in clinical decision-making.