Table 1.
Questions asked during the online survey. (*) for questions with multiple answers possible.
| Questions | |||
|---|---|---|---|
| Have you previously treated COVID-19 patients in your ICU? | |||
| Yes | No | ||
| Please tell us how many COVID-19 patients you have provided on your ICU to date. | |||
| Exact number | Estimated number | Specification not possible | |
| Please list the number of beds in your hospital. | |||
| <200 | 200–600 | 600–1000 | >1000 |
| Please list any special technical equipment available in your ICU. (*) | |||
| Extracorporeal membrane oxygenation (ECMO) | Pumpless extracorporeal membrane oxygenation (pECLA) | ||
| Renal replacement therapy (24 h available) | Advanced hemodynamic monitoring (PiCCO, Swan–Ganz catheter) | ||
| Advanced respiratory monitoring (NAVA, EIT, etc.) | Adaptive ventilation modes (NAVA, PAV, PAV+, etc.) | ||
| NO inhalation therapy | Cytokine elimination procedures | ||
| Please describe your approach to ventilation in COVID-19 patients compared to other patients with respiratory failure. (*) | |||
| Intubation exclusively as last resort (prolonged NIPPVV, HFNC etc.) | Early decision for intubation and invasive ventilation | ||
| Early decision for extracorporeal procedures (ECMO, pECLA) | Performance and consideration of “awake ECMO”. | ||
| Basically, no difference to the procedure described in the German level 3 guideline for ARDS patients. | |||
| Describe the discontinuation criteria for NIV ventilation in COVID-19 patients. | |||
| Consciousness disorder | Respiratory rate | Clinical assessment of the respiratory work | |
| Rapid-Shallow-Breathing-Index | CO2 elimination disorder | Horovitz/oxygenation index | Work of breathing |
| If you are using RSBI as a discontinuation criterion for NIV therapy, explain your threshold. | |||
| If you are using Horovitz as a discontinuation criterion for NIV therapy, explain your threshold. | |||
| If you are using respiratory rate as a discontinuation criterion for NIV therapy, explain your threshold. | |||
| If you are using work of breathing as a discontinuation criterion for NIV therapy, explain your threshold. | |||
| If you are using pCO2 as a discontinuation criterion for NIV therapy, explain your threshold. | |||
| What alternative procedures are used instead of invasive ventilation in your ICU for critically ill COVID-19 patients. (*) | |||
| Oxygen therapy only | High-flow nasal oxygen (HFNC) | ||
| Conventional non-invasive ventilation via mask | Alternative NIV interface (helmets, etc.) | ||
| If you use an HFNC, what flow rates are used in critically ill COVID-19 patients? | |||
| HFNC as usual | No HFNC due to potential aerosol exposure for personnel | ||
| Reduced flow rates compared to non-COVID to reduce aerosol production | |||
| Please describe your approach to proning in non-intubated COVID-19 patients with severely impaired lung function in your ICU. | |||
| Instruction for self-positioning of patients in prone position (“self-proning”) | |||
| 130°-positioning or lateral-positioning | No proning in patients without invasive ventilation | ||
| Please describe your approach to proning in intubated COVID-19 patients with severely impaired lung function in your ICU. | |||
| Early proning (already above P/F ratio of 150) | Prone positioning only in patients with proven potential of recruitment | ||
| Restrained indication for proning | No proning | ||
| No difference to the described procedure in the German level 3 guideline for ARDS patients. | |||
| What tools do you use to adjust PEEP in COVID-19 patients? (*) | |||
| ARDS Network Table | Best PEEP-Trial | Open-lung-tool/P-V maneuver | Recruitment CT-Scan |
| None of these methods | Transpulmonary pressure measurement | ||
| If you are using the ARDS network table to set PEEP, which table are you using as? | |||
| low PEEP table | high PEEP table | No use of the PEEP table | |
| Are you using permanent (>24 h) neuromuscular blockade in COVID-19 patients to improve ventilation? | |||
| Yes | No | Only in individual cases | |
| In COVID-19 patients * with severe ARDS, are you already early aiming for spontaneous breathing? | |||
| Yes | No | Only in individual cases | |
| Which tracheostomy procedure do you use for critically ill COVID-19 patients? | |||
| Preferred surgical tracheostomy to reduce aerosol exposure to staff | Preferred puncture tracheotomy to reduce aerosol exposure to staff | ||
| Both procedures, choice based on anatomic structures | No tracheotomy in COVID-19 patients | ||
| Please describe the tracheostomy timing in COVID-19 patients compared to other ARDS patients. | |||
| Earlier | Later | No difference | |