Alarms and alarm management with automated versus conventional ventilation in neurocritical care patients
Issued Date
2026-12-01
Resource Type
ISSN
09643397
eISSN
15324036
Scopus ID
2-s2.0-105041991186
Journal Title
Intensive and Critical Care Nursing
Volume
97
Rights Holder(s)
SCOPUS
Bibliographic Citation
Intensive and Critical Care Nursing Vol.97 (2026)
Suggested Citation
van Limpt G.J.C., van Vliet P., Molenaar M.A., de Bie A.J.R., van Haren L., van Leijsen T.D., Robba C., Sinnige J.S., Horn J., Neto A.S., Paulus F., Schultz M.J., Buiteman–Kruizinga L.A. Alarms and alarm management with automated versus conventional ventilation in neurocritical care patients. Intensive and Critical Care Nursing Vol.97 (2026). doi:10.1016/j.iccn.2026.104471 Retrieved from: https://repository.li.mahidol.ac.th/handle/123456789/117445
Title
Alarms and alarm management with automated versus conventional ventilation in neurocritical care patients
Author's Affiliation
Monash University
Amsterdam UMC - University of Amsterdam
Medizinische Universität Wien
IRCCS Azienda Ospedaliera Metropolitana
Nuffield Department of Medicine
Hospital Israelita Albert Einstein
Austin Hospital
Kantonsspital St.Gallen
Catharina Ziekenhuis
HMC
Mahidol Oxford Tropical Medicine Research Unit
Reinier de Graaf Hospital - SSDZ
Department of Critical Care
Amsterdam UMC - University of Amsterdam
Medizinische Universität Wien
IRCCS Azienda Ospedaliera Metropolitana
Nuffield Department of Medicine
Hospital Israelita Albert Einstein
Austin Hospital
Kantonsspital St.Gallen
Catharina Ziekenhuis
HMC
Mahidol Oxford Tropical Medicine Research Unit
Reinier de Graaf Hospital - SSDZ
Department of Critical Care
Corresponding Author(s)
Other Contributor(s)
Abstract
Introduction: False or clinically irrelevant alarms are a major driver of ICU alarm fatigue and nursing workload. Ventilator alarms make up a large share, and although automated ventilation modes can reduce manual adjustments, their effect on alarm burden is still unclear. This issue can be particularly relevant in neurocritical care patients, where precise ventilator and alarm management is imperative for patient safety. Objectives: This explorative post hoc analysis of a randomized clinical trial compared alarm frequency and management between automated ventilation and conventional ventilation in neurocritical care patients. Methods: Ventilator alarms and manual ventilator changes were captured continuously from the ventilator for up to 24 h per patient. The primary endpoint was a composite of workload-relevant alarms; with alarm management interventions at the ventilator as a key secondary outcome. Additional endpoints included redundant alarms, alarm duration and ventilator management. Results: 13 patients received automated ventilation and 24 received conventional ventilation. No difference was observed in workload-relevant alarm frequency between automated and conventional ventilation (3.28 [2.87 to 4.30] vs 3.73 [1.66 to 7.33] alarms per hour; P = 0.81), while alarm management interventions at the ventilator were lower with automated ventilation (0.14 [0.10 to 0.15] vs 0.21 [0.17 to 0.31] interventions per hour; P = 0.01). Other alarm frequencies, duration of alarms and ventilator management were similar. Conclusions: In this exploratory post hoc analysis of a randomized clinical trial in neurocritical care patients during the early phase of mechanical ventilation, automated ventilation did not reduce the frequency of total or workload-relevant alarms, nor their duration, but was associated with fewer alarm management interventions compared to conventional ventilation. Implications for clinical practice: Automated ventilation may not reduce alarm frequency in neurocritical care patients, but the observed reduction in alarm-related bedside interventions suggests a potential benefit for nursing workload.