TY - JOUR
T1 - Saudi Guideline for Mechanical Ventilation in Adults
AU - Arabi, Yaseen M.
AU - Al Aseri, Zohair
AU - Rada, Gabriel
AU - Abdulmomen, Ahmed A.
AU - Alenezi, Farhan
AU - Albshabshe, Ali
AU - Aldekhyl, Sara
AU - Algahtani, Ahmed
AU - Algethamy, Haifa M.
AU - Al-Hameed, Fahad M.
AU - Al Harbi, Mohammed K.
AU - Alhazzani, Waleed
AU - Aljasser, Tariq
AU - Aljuaid, Maha
AU - Al Matrood, Amal
AU - Al Mutairi, Mohammed M.
AU - Alobeiwi, Khalid Naif
AU - Alqahtani, Samah Y.
AU - Alqahtani, Mohammed A.
AU - Al Reyes, Khalid
AU - Alshahrani, Mohammed
AU - Azzam, Mohamed H.
AU - Elhazmi, Alyaa
AU - Mady, Ahmed
AU - Maghrabi, Khalid
AU - Mhawish, Huda A.
AU - Zeitouni, Mohammed O.
AU - Memish, Ziad A.
AU - Saeedi, Mohammad
AU - Alqahtani, Abdulrahman
AU - Abuzinada, Shatha
AU - Cantor-Cruz, Francy
AU - Oliver-Avila, Camila
AU - Novillo, Francisco
AU - Rojas-Gómez, Ana Maria
AU - Ramos-Rojas, José
AU - Verdugo-Paiva, Francisca
AU - Peña, Javiera
AU - Veloso, Valentina
AU - Zambrano, Paula
AU - Valson, Joanna
AU - Alvira, Ximena
AU - Bilimoria, Khushnam
AU - Taneja, Chirag
AU - Phuong, Mai Ta
AU - Chawla, Ruchi
AU - Feit, Sheila
AU - Bickett, Skye
AU - Brunnhuber, Klara
N1 - Publisher Copyright:
© 2026 Saudi Journal of Medicine & Medical Sciences.
PY - 2026/2/1
Y1 - 2026/2/1
N2 - Background: Mechanical ventilation is a critical intervention for patients with respiratory failure. Recent advancements and quality improvement initiatives in Saudi Arabia have contributed to refining mechanical ventilation practices. This guideline represents the first national evidence-based framework developed through a multidisciplinary approach. Objectives: This guideline provides evidence-based recommendations for the management of mechanically ventilated adults in intensive care units in Saudi Arabia, incorporating best practices to improve patient outcomes and standardize care across healthcare institutions. Methods: The guideline development followed the Grading of Recommendations Assessment, Development, and Evaluation (GRADE)-ADOLOPMENT methodology, an internationally accepted approach for adopting, adapting, and developing guidelines. A multidisciplinary task force, comprising intensivists, pulmonologists, anaesthesiologists, respiratory therapists, and nursing specialists, conducted a systematic review of the literature and contextualized recommendations for local healthcare settings. The guideline addressed 14 prioritized questions. Results: The guideline included strong recommendations for using low tidal volume ventilation for patients with ARDS, utilizing higher levels of positive end-expiratory pressure, and employing head-of-bed elevation. The guideline provided conditional recommendations for using veno-venous extracorporeal membrane oxygenation, daily sedation interruption, protocolized spontaneous breathing trials, prone positioning, using an endotracheal tube with subglottic secretion drainage, using light sedation, and early tracheostomy. The guideline also included a conditional recommendation against using nitric oxide and a neutral recommendation regarding recruitment maneuvers and early mobility. Conclusion: This guideline serves as a foundational framework for optimizing mechanical ventilation practices in Saudi Arabia. Future research should focus on local implementation strategies, cost-effectiveness analysis, and the impact of guideline adherence on clinical outcomes.
AB - Background: Mechanical ventilation is a critical intervention for patients with respiratory failure. Recent advancements and quality improvement initiatives in Saudi Arabia have contributed to refining mechanical ventilation practices. This guideline represents the first national evidence-based framework developed through a multidisciplinary approach. Objectives: This guideline provides evidence-based recommendations for the management of mechanically ventilated adults in intensive care units in Saudi Arabia, incorporating best practices to improve patient outcomes and standardize care across healthcare institutions. Methods: The guideline development followed the Grading of Recommendations Assessment, Development, and Evaluation (GRADE)-ADOLOPMENT methodology, an internationally accepted approach for adopting, adapting, and developing guidelines. A multidisciplinary task force, comprising intensivists, pulmonologists, anaesthesiologists, respiratory therapists, and nursing specialists, conducted a systematic review of the literature and contextualized recommendations for local healthcare settings. The guideline addressed 14 prioritized questions. Results: The guideline included strong recommendations for using low tidal volume ventilation for patients with ARDS, utilizing higher levels of positive end-expiratory pressure, and employing head-of-bed elevation. The guideline provided conditional recommendations for using veno-venous extracorporeal membrane oxygenation, daily sedation interruption, protocolized spontaneous breathing trials, prone positioning, using an endotracheal tube with subglottic secretion drainage, using light sedation, and early tracheostomy. The guideline also included a conditional recommendation against using nitric oxide and a neutral recommendation regarding recruitment maneuvers and early mobility. Conclusion: This guideline serves as a foundational framework for optimizing mechanical ventilation practices in Saudi Arabia. Future research should focus on local implementation strategies, cost-effectiveness analysis, and the impact of guideline adherence on clinical outcomes.
KW - Acute respiratory distress syndrome
KW - lung-protective ventilation
KW - mechanical ventilation
KW - Saudi Arabia
KW - sedation
KW - ventilator-associated pneumonia
KW - weaning strategies
UR - https://www.scopus.com/pages/publications/105030177160
U2 - 10.4103/sjmms.sjmms_327_25
DO - 10.4103/sjmms.sjmms_327_25
M3 - Review article
AN - SCOPUS:105030177160
SN - 1658-631X
VL - 14
SP - S7-S35
JO - Saudi Journal of Medicine and Medical Sciences
JF - Saudi Journal of Medicine and Medical Sciences
ER -
SDG 3 Good Health and Well-being