Background: Communication with patients undergoing mechanical ventilation in the intensive care unit represents a challenge. The aims of the study were (1) to describe communication difficulties related to mechanical ventilation as experienced by healthcare professionals and patients, and (2) to compare the use of a conventional low-tech communication board and a high-tech eye tracking technology-based device to improve communication effectiveness of mechanically ventilated patients in intensive care. Methods: This prospective study consisted of a descriptive cross-sectional part describing the communication difficulties in the intensive care unit and an experimental randomized crossover part comparing the use of two technologically opposed augmentative and alternative communication interfaces. A mixed method approach was applied with a quantitative primary method and a qualitative complementary method. The numerical data were analyzed quantitatively using Mann-Whitney (ordinal variables) and chi-square (binary variables) nonparametric tests. The non-numerical data were analyzed qualitatively using thematization and categorization. Results: A total of 101 healthcare professionals and 44 patients participated. Regarding the descriptive part, the communication difficulty analysis confirmed that mechanical ventilation constitutes a major problem in patient-caregiver communication. Regarding the quantitative experimental part, the treatment effects on transmitted messages quantity (2 median messages per exchange for the board versus 4 median messages per exchange for the eye tracking, p < 0.0001), success rate (80% for the board versus 100% for the eye tracking, p < 0.05) and patient satisfaction (68% negative satisfaction level for the board versus 100% positive satisfaction level for eye tracking, p < 0.0001) were significant. Regarding the qualitative experimental part, the communication content covered 8 themes for the board compared to 9 themes for the eye tracking and the use difficulties included 4 categories for the board as well as for the eye tracking. Conclusion: The eye tracking device may further improve communication effectiveness of mechanically ventilated patients compared to the conventional communication board, both quantitatively and qualitatively. Trial registration: Communication Strategies for Mechanically Ventilated Patients in Intensive Care Units, NCT05651984. Retrospectively registered on December 02, 2022 (https://clinicaltrials.gov/ct2/show/NCT05651984?term=NCT05651984&draw=2&rank=1).

Purpose: Communication with patients undergoing mechanical ventilation in the intensive care unit represents a challenge. The aims of the study were (1) to describe communication difficulties related to mechanical ventilation as experienced by caregivers and patients, and (2) to compare the use of a conventional low-tech communication board and a high-tech eye tracking technology-based device in order to improve communication effectiveness of mechanically ventilated patients in intensive care. Methods: This prospective study consisted of a descriptive cross-sectional part describing the communication difficulties in the intensive care unit and an experimental randomized crossover part comparing the use of two technologically opposed augmentative and alternative communication interfaces. A mixed method approach was applied with a quantitative primary method and a qualitative complementary method. Results: A total of 101 caregivers and 44 patients participated. Regarding the descriptive part, the communication difficulty analysis confirmed that mechanical ventilation constitutes a major problem in patient-caregiver communication. Regarding the quantitative experimental part, the treatment effects on transmitted messages quantity (2 median messages per exchange for the board versus 4 median messages per exchange for the eye tracking, p < 0.0001), success rate (80% for the board versus 100% for the eye tracking, p < 0.05) and patient satisfaction (68% negative satisfaction level for the board versus 100% positive satisfaction level for eye tracking, p < 0.0001) were significant. Regarding the qualitative experimental part, the communication content covered 8 themes for the board compared to 9 themes for the eye tracking and he use difficulties included 4 categories for the board as well as for the eye tracking. Conclusion: The eye tracking device may improve communication effectiveness of mechanically ventilated patients compared to the conventional communication board, both quantitatively and qualitatively.

<b><i>Introduction:</i></b> Currently, INSURE (Intubation-Surfactant-Extubation) and LISA (Less Invasive Surfactant Administration) are two recommended techniques for surfactant delivery to newborns with respiratory distress syndrome. The aim of this study was to evaluate the feasibility, safety, tolerability of a new technique of surfactant administration in newborns without anesthesia or laryngoscopy: Fiberscope Assisted Surfactant Therapy (FAST). <b><i>Methods:</i></b> This monocentric, prospective, nonrandomized, pilot feasibility study was conducted from January to December 2021. Spontaneously breathing infants born ≥28 weeks gestational age with respiratory distress syndrome received surfactant by a 1.5 French catheter inserted in the trachea using a flexible endoscope without anesthesia, while maintaining a continuous positive expiratory pressure. The learning curve of this new technique by caregivers was studied during training sessions on high fidelity mannequins. <b><i>Results:</i></b> Eight infants born ≥28 weeks of gestation with a birth weight of 1,000 g–2,685 g were included in the study. FAST was successfully performed in each case without anesthesia, second dose of surfactant or mechanical ventilation. One hour after FAST, a decrease of FiO₂ and PCO₂ and an increase of arterial pressure and pH were recorded with medians of individual differences of −0.9, −4 mm Hg, 6.5 mm Hg, and 0.06, respectively. The learning curves of 13 physicians showed a rapid mastery of FAST from the third attempt onwards (mean duration of 113, 66, and 50 s for 1st, 2nd, and 3rd attempts, respectively, 29–37 s for further attempts). <b><i>Conclusion:</i></b> FAST may be considered as a possible new minimally invasive surfactant therapy technique for neonates ≥28 weeks with mild respiratory distress syndrome.

Purpose: Communication with patients undergoing mechanical ventilation in the intensive care unit represents a challenge. The aims of the study were (1) to describe communication difficulties related to mechanical ventilation as experienced by caregivers and patients, and (2) to compare the use of a conventional low-tech communication board and a high-tech eye tracking technology-based device in order to improve communication effectiveness of mechanically ventilated patients in intensive care.Methods: This prospective study consisted of a descriptive cross-sectional part describing the communication difficulties in the intensive care unit and an experimental randomized crossover part comparing the use of two technologically opposed augmentative and alternative communication interfaces. A mixed method approach was applied with a quantitative primary method and a qualitative complementary method.Results: A total of 101 caregivers and 44 patients participated. Regarding the descriptive part, the communication difficulty analysis confirmed that mechanical ventilation constitutes a major problem in patient-caregiver communication. Regarding the quantitative experimental part, the treatment effects on transmitted messages quantity (2 median messages per exchange for the board versus 4 median messages per exchange for the eye tracking, p < 0.0001), success rate (80% for the board versus 100% for the eye tracking, p < 0.05) and patient satisfaction (68% negative satisfaction level for the board versus 100% positive satisfaction level for eye tracking, p < 0.0001) were significant. Regarding the qualitative experimental part, the communication content covered 8 themes for the board compared to 9 themes for the eye tracking and he use difficulties included 4 categories for the board as well as for the eye tracking. Conclusion: The eye tracking device may improve communication effectiveness of mechanically ventilated patients compared to the conventional communication board, both quantitatively and qualitatively.