Date of Award

Spring 3-31-2023

Degree Type


Degree Name

Master of Science (MS)


Respiratory Therapy

First Advisor

Ralph Zimmerman, PhD,RRT-NPS,FAARC

Second Advisor

Kyle Brandenberger, PhD

Third Advisor

Robert B. Murray, MS, RRT


Background: Pediatric acute respiratory distress syndrome (PARDS) significantly contributes to morbidity and mortality in young children. Children with PARDS often require intensive care admission and mechanical ventilation. Unfortunately, not much information is available to support management strategies in PARDS beyond lung protective ventilation. Examining proper mechanical ventilation techniques such as Airway Pressure Release Ventilation mode (APRV) that can support and manage these patients. Respiratory therapists' beliefs and practices of using mechanical ventilation are essential to establish guidelines for managing ventilated PARDS cases. Purpose: This study aims to evaluate the prevalence and attitude of APRV mode with PARDS patients among respiratory therapists in Saudi Arabia. Methods: The study used an online, cross-sectional survey with 22 questions administered to a convenience sample of respiratory therapists in Saudi Arabia. The survey was divided into three sections to obtain information from respondents. These sections are demographic data, the prevalence of utilizing APRV on patients with PARDS, and attitudes regarding APRV with PARDS. Results: seventy-seven responses were received from the online survey sent to respiratory therapy departments in different regions across Saudi Arabia. Three participants refused to participate, and n=20 (28,5%) of responders did not complete the survey, and their answers were excluded. Therefore, n=54 (70,1%) respondents completed the survey. The result showed that most participants have a bachelor's degree (n=43, 79,6%), master's degree (n= 8, 14,8%), associate degree (n= 2, 3.7%), and only one participant have a Ph.D. degree (n=1, 1.9). Most participants were males (n= 34, 63%). At the same time, the females were (n=20, 37%). Most of the responses were from the middle region (n=28, 51.9. The majority of respondents worked in a governmental hospital (n=52, 96.3%), while two worked in private hospitals (n=2 ,3.7%). Half of the respondents (n=27, 50%) reported that their hospital uses the APRV mechanical ventilation mode with pediatric ARDS patients. Among those who reported using APRV mode, only (n=9, 33.3%) reported following the current guidelines of the Pediatric Acute Lung Injury Consensus Conference (PALICC). In comparison, (n=6, 22.2%) reported not following the guidelines, and (n=12, 44.4%) were unsure. The findings suggest variation in the respiratory therapists' experience and confidence in using APRV. However, most participants believe it is a safe ventilation mode and can be used as both an initial and rescue mode. Conclusion: the study reveals variations in the experience and confidence of respiratory therapists in using APRV, which may influence their willingness to use it in pediatric patients with ARDS. Most participants, however, believe it is a safe ventilation mode that can be used as both an initial and rescue mode. The results of this study could inform the development of training programs and protocols designed to improve respiratory therapists' knowledge and confidence in using APRV and to promote its consistent use in pediatric patients with ARDS.


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