PROVE Network - alarms & alarm management

alarms & alarm management

Connect with Laura Buiteman or Frederique Paulus for general inquiries about the featured projects; each project includes a specific contact address for trial–related questions

INtensive care Technology and Alarm burden for CriTical care nurses (INTACT) – exploring ICU nursing workload and human–technology interaction

in the ICU, nurses manage complex ventilators that generate frequent alarms; many are not urgent, causing stress and extra work; INTACT examines alarm frequency, nurse–ventilator interaction, and impacts on workload and wellbeing using eye–tracking, time–motion analyses, and surveys; patients and families share how alarms affect sleep, stress, and trust; in collaboration with hospitals, universities, and industry, we test improved alarm settings and designs; our aim is to ease nurse workload and understand how technology shapes care; we use a multidisciplinary approach involving doctors, patients, and other professionals

[1] Delphi

a Delphi study will gather expert perspectives on the role and management of alarms associated with mechanical ventilation

the panel will comprise ICU nurses, respiratory therapists, physical therapists, ventilation specialists, and intensivists

the objective is to establish consensus on the clinical significance of specific alarms, best practices for addressing them on ventilators, and identifying alarms that are particularly time–consuming or challenging to manage

the study will be registered at clinicaltrials (pending), and the protocol is currently under development

connect with Geertje van Limpt or Laura Buiteman for information on this Delphi

[2] scoping review

this scoping review aims to identify and evaluate the various methods to used to measure the workload of healthcare professionals in ICUs; it focuses on methods used to assess workload associated with advanced technologies, in particular mechanical ventilation and other forms of respiratory support

this review will provide a comprehensive overview that highlights gaps in current practices and suggests areas for future development

this review is registered at OSF registries (osf.io/yq4m7); the protocol is submitted for prepublishment

connect with Geertje van Limpt or Laura Buiteman for information on this review

[3] INTELLiSTREAM

this is a preplanned analysis of the ‘Closed–loop ventilation using sidestream versus mainstream capnography for automated adjustment of alveolar minute ventilation’ (INTELLiSTREAM) singlecenter randomized clinical trial in 73 patients after cardiac surgery

this preplanned analysis focused on alarms, interventions at the ventilator, and acceptance of caregiver to assess closed–loop ventilation usability

INTELLiSTREAM is registered at clinicaltrials (NCT04599491); the analysis is ongoing

connect with Laura Buiteman or Frederique Paulus for information on this study

[4] POSITiVE

this is a preplanned analysis of the ‘Fully automated postoperative ventilation in cardiac surgery patients’ (POSITiVE) singlecenter randomized clinical trial that determined the effect of automated ventilation by means of INTELLiVENT–ASV versus ventilation that was not automated on the quality of breathing in 220 patients after cardiac surgery

this preplanned analysis focused on alarms, interventions at the ventilator, and acceptance of caregiver to assess closed–loop ventilation usability

POSITiVE is registered at clinicaltrials (NCT03180203); the manuscript was published in Intensive Crit Care Nurs (2025; 89:103963)

[5] INTELLiOXY

the ‘The effect of closed–loop versus conventional ventilation on oxygen and PEEP settings’ (INTELLiOXY) is a substudy of ‘The effect of closed–loop versus conventional ventilation on mechanical power’ (INTELLiPOWER) international multicenter randomized crossover trial, and determined the effect of INTELLiVENT–ASV versus conventional ventilation on oxygen and PEEP titrations, and alarms related to oxygen in a subset of patients in whom granular, breath–by–breath data are collected

the parent study was registered at clinicaltrials (NCT04827927); the primary analysis was published in J Clin Med (2024; 14:41)

more information can be found above, in the description of the parent INTELLiPOWER study

connect with Laura Buiteman or Frederique Paulus for information on this study

[6] ACTIVE

this is a preplanned analysis of the ‘Effect of automated closed–loop ventilation versus conventional ventilation on duration and quality of ventilation in critically ill patients’ (ACTiVE)

this analysis focuses on the alarms and alarm management in neuro–critical care patients

breath–by–breath data will be used, and relevant alarms and their management will be identified by an expert panel of ICU nurses and ventilation practitioners

ACTiVE is registered at clinicaltrials (NCT04593810); the study protocol was published in TRIALS (2022; 23:348); the analysis is currently ongoing

[7] BRAVE

the ‘Brain Recovery with Automated Ventilation’ (BRAVE) crossover clinical trial that compared INTELLiVENT–ASV with conventional ventilation in patients with acute brain injury, focusing on both brain– and lung–protection

this analysis focuses on the alarms and alarm management in neuro–critical care patients

breath–by–breath data will be used, and relevant alarms and their management will be identified by an expert panel of ICU nurses and ventilation practitioners

BRAVE is registered at clinicaltrials (NCT06367816); the analysis will be ready soon

connect with us if you want to join one of the running projects of INTACT

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