New study to change how patients are cared for in Intensive Care Units

In a new study published today in the New England Journal of Medicine and presented at the Society of Critical Care Medicine conference, researchers showed that the method of ventilating patients in Intensive Care Units can significantly impact their risk of mortality.

Lead authors Dr. Niall Ferguson, Director of Critical Care at Mount Sinai Hospital and University Health Network and Dr. Maureen Meade, Professor of Medicine at McMaster University studied patients suffering from Acute Respiratory Distress Syndrome (ARDS), a life-threatening illness that can be caused by pneumonia, trauma or serious infections.

They conducted a multicentre, randomized controlled trial in 39 Intensive Care Units from five countries, including Toronto General Hospital, Toronto Western Hospital, Mount Sinai Hospital and Hamilton Health Sciences, in which adults suffering from new-onset, moderate-to-severe ARDS were randomized to receive either a novel form of ventilation designed to protect the lung called high-frequency oscillatory ventilation (HFOV) or to receive lung-protective conventional ventilation. 

The researchers found that patients treated with HFOV had a higher mortality and they required more sedation and more drugs to support their blood pressure. As a result, the study recommends that clinicians should use the conventional lung-protective strategy in most cases. 

“This study will change how we ventilate our patients who are suffering from Acute Respiratory Distress Syndrome,” said Dr. Niall Ferguson, Director of Critical Care at University Health Network and Mount Sinai Hospital. “We previously thought that the benefits of HFOV in protecting patients’ lungs would outweigh its risks, but based on this study, we know that this is not the case. Our research demonstrates the importance of conducting clinical research in Intensive Care Units so that we can ensure we are providing the best patient care to our sickest patients.”

Patients who are treated in Intensive Care Units (ICU) are the sickest patients in a hospital, suffering from life-threatening conditions such as infections, cancer and trauma. Of the patients who are treated in ICUs each year in Canada, two-thirds are on ventilators and of those, 10% suffer from ARDS.

The study was funded by the Canadian Institutes of Health Research.