The Role of Respiratory Therapists and Nursing in Managing Acute Respiratory Distress Syndrome (ARDS): A Cross-Sectional Study

Abstract

An acute respiratory distress syndrome (ARDS) cross-sectional study was conducted in a large teaching hospital with medical and surgical intensive care units (ICUs) to assess the ventilatory strategies, patterns of noninvasive ventilatory support, and early rehabilitation practices of respiratory therapists (RTs). Objective clinical data collected from a representative sample of ARDS patients were linked with a novel RT-led ARDS management workflow. Specific actions taken by RTs for suspected and confirmed ARDS cases, anticipated clinical benefits, and the effect on each patient’s trajectory were documented. The analysis indicates that RT-led ARDS management supports a number of high-impact interventions and quality indicators associated with better clinical outcomes.

Acute respiratory distress syndrome (ARDS) is a sudden, life-threatening pulmonary disorder characterized by abnormal gas-exchange mechanisms that require immediate attention. It is often associated with pneumonia, sepsis, aspiration, trauma, and other causative factors. The clinical presentation involves progressive dyspnea, hypoxemia, diffuse infiltrates, and stiff lungs. ARDS is common in critically ill patients and considered the leading cause of death in intensive care units (ICUs) . The diagnosis of ARDS can be established with minimal expertise, and the clinical uncertainties related to patients who are already ventilated may make recognition challenging. The management of patients with ARDS is complex and characterized by various ventilatory strategies, modes of noninvasive support, and rehabilitation practices. Therefore, this study aimed to understand the current clinical reality of ARDS management in a large academic hospital where respiratory therapists (RT) are members of the multidisciplinary team, in order to develop and implement an RT-led ARDS management protocol.