{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,20]],"date-time":"2026-04-20T17:10:49Z","timestamp":1776705049768,"version":"3.51.2"},"reference-count":39,"publisher":"Oxford University Press (OUP)","issue":"1","license":[{"start":{"date-parts":[[2017,1,1]],"date-time":"2017-01-01T00:00:00Z","timestamp":1483228800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2017,1,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Rationale<\/jats:title>\n                    <jats:p>Adoption and de-adoption of adjuvant strategies to mechanical ventilation for acute respiratory failure (ARF), and factors associated with their selection, have not been extensively evaluated.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>To evaluate change in use of adjuvants to mechanical ventilation for ARF (2008\u20132013), the impact of landmark publications on adoption and de-adoption, and factors associated with use.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Changes in use of four adjuvants for ARF from 2008 to 2013, the impact of landmark publications on use, and factors associated with use were evaluated with the Premier Database. Extracorporeal membrane oxygenation (ECMO), inhaled nitric oxide, inhaled epoprostenol, and continuous neuromuscular blockading agents (cNMBAs) in adult mechanically ventilated patients were identified on the basis of International Classification of Diseases, Ninth Revision, Clinical Modification codes and billing data.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Measurements and Main Results<\/jats:title>\n                    <jats:p>Among 514,913 patients with ARF, 11,567 (2.3%) were treated with at least one adjuvant. cNMBAs were the most frequently used adjuvants (n\u2009=\u200910,073, 2.1% in capable hospitals), followed by inhaled pulmonary vasodilators (n\u2009=\u20091,878, 1.0% in capable hospitals; 58% nitric oxide), and ECMO (n\u2009=\u2009195, 0.2% in capable hospitals). There was an increase in ECMO and inhaled epoprostenol over time but no change in nitric oxide or cNMBAs. Segmented regression analysis was used to evaluate whether clinical practice was in accordance with emerging evidence from landmark studies. Using the relevant landmark publication dates, these analyses did not reveal any change in use over time after publication with the exception of inhaled epoprostenol\u2014for which rates of growth decreased over time, possibly in response to the evidence. There was a significant amount of variability in patient and hospital factors associated with use with between adjuvants.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Between 2008 and 2013, there was an increase in use of ECMO and inhaled epoprostenol, and no change in use of inhaled nitric oxide or continuous intravenous infusion of a neuromuscular blocking agent. There was considerable variability in patient and hospital factors associated with use across different adjuvants.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1513\/annalsats.201606-438oc","type":"journal-article","created":{"date-parts":[[2016,10,13]],"date-time":"2016-10-13T22:40:08Z","timestamp":1476398408000},"page":"94-102","source":"Crossref","is-referenced-by-count":15,"title":["Adjuvants to Mechanical Ventilation for Acute Respiratory Failure. Adoption, De-adoption, and Factors Associated with Selection"],"prefix":"10.1093","volume":"14","author":[{"given":"Laveena","family":"Munshi","sequence":"first","affiliation":[{"name":"Interdepartmental Division of Critical Care, Mount Sinai Hospital, University Health Network, and University of Toronto, Toronto, Ontario, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hayley B.","family":"Gershengorn","sequence":"additional","affiliation":[{"name":"Division of Critical Care, Montefiore Medical Center, Albert Einstein College of Medicine, New York, New York"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Eddy","family":"Fan","sequence":"additional","affiliation":[{"name":"Interdepartmental Division of Critical Care, Mount Sinai Hospital, University Health Network, and University of Toronto, Toronto, Ontario, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hannah","family":"Wunsch","sequence":"additional","affiliation":[{"name":"Interdepartmental Division of Critical Care, Sunnybrook Health Sciences Center, and University of Toronto, Toronto, Ontario, Canada; and"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Niall D.","family":"Ferguson","sequence":"additional","affiliation":[{"name":"Interdepartmental Division of Critical Care, Mount Sinai Hospital, University Health Network, and University of Toronto, Toronto, Ontario, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Therese A.","family":"Stukel","sequence":"additional","affiliation":[{"name":"Clinical Epidemiology and Health Care Research Program, Institute for Clinical Evaluative Sciences, Sunnybrook Health Sciences Centre and University of Toronto, Toronto, Ontario, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gordon D.","family":"Rubenfeld","sequence":"additional","affiliation":[{"name":"Interdepartmental Division of Critical Care, Sunnybrook Health Sciences Center, and University of Toronto, Toronto, Ontario, Canada; and"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2017,1,1]]},"reference":[{"key":"2026020402580383000_bib1","doi-asserted-by":"crossref","first-page":"788","DOI":"10.1001\/jama.2016.0291","article-title":"Epidemiology, patterns of care, and mortality for patients with acute respiratory distress syndrome in intensive care units in 50 countries","volume":"315","author":"Bellani","year":"2016","journal-title":"JAMA"},{"key":"2026020402580383000_bib2","article-title":"Randomised control trial of humidified high flow nasal cannulae versus standard oxygen in the emergency department","author":"Bell","journal-title":"Emerg Med Australas"},{"key":"2026020402580383000_bib3","doi-asserted-by":"crossref","first-page":"2159","DOI":"10.1056\/NEJMoa1214103","article-title":"Prone positioning in severe acute respiratory distress syndrome","volume":"368","author":"Gu\u00e9rin","year":"2013","journal-title":"N Engl J Med"},{"key":"2026020402580383000_bib4","doi-asserted-by":"crossref","first-page":"1351","DOI":"10.1016\/S0140-6736(09)61069-2","article-title":"Efficacy and economic assessment of Conventional Ventilatory Support versus Extracorporeal Membrane Oxygenation for Severe Adult Respiratory Failure (CESAR): a multicentre randomised controlled trial","volume":"374","author":"Peek","year":"2009","journal-title":"Lancet"},{"key":"2026020402580383000_bib5","doi-asserted-by":"crossref","first-page":"276","DOI":"10.1164\/rccm.201205-0815OC","article-title":"Extracorporeal membrane oxygenation for pandemic influenza A (H1N1)-induced acute respiratory distress syndrome: a cohort study and propensity-matched analysis","volume":"187","author":"Pham","year":"2013","journal-title":"Am J Respir Crit Care Med"},{"key":"2026020402580383000_bib6","doi-asserted-by":"crossref","first-page":"1659","DOI":"10.1001\/jama.2011.1471","article-title":"Referral to an extracorporeal membrane oxygenation center and mortality among patients with severe 2009 influenza A (H1N1)","volume":"306","author":"Noah","year":"2011","journal-title":"JAMA"},{"key":"2026020402580383000_bib7","doi-asserted-by":"crossref","first-page":"795","DOI":"10.1056\/NEJMoa1215554","article-title":"High-frequency oscillation in early acute respiratory distress syndrome","volume":"368","author":"Ferguson","year":"2013","journal-title":"N Engl J Med"},{"key":"2026020402580383000_bib8","doi-asserted-by":"crossref","first-page":"806","DOI":"10.1056\/NEJMoa1215716","article-title":"High-frequency oscillation for acute respiratory distress syndrome","volume":"368","author":"Young","year":"2013","journal-title":"N Engl J Med"},{"key":"2026020402580383000_bib9","doi-asserted-by":"crossref","first-page":"90","DOI":"10.1097\/CCM.0b013e31829eb7c9","article-title":"Treatment with neuromuscular blocking agents and the risk of in-hospital mortality among mechanically ventilated patients with severe sepsis","volume":"42","author":"Steingrub","year":"2014","journal-title":"Crit Care Med"},{"key":"2026020402580383000_bib10","doi-asserted-by":"crossref","first-page":"779","DOI":"10.1136\/bmj.39139.716794.55","article-title":"Effect of nitric oxide on oxygenation and mortality in acute lung injury: systematic review and meta-analysis","volume":"334","author":"Adhikari","year":"2007","journal-title":"BMJ"},{"key":"2026020402580383000_bib11","doi-asserted-by":"crossref","first-page":"756","DOI":"10.1007\/s00134-016-4331-6","article-title":"Personalized medicine for ARDS: the 2035 research agenda","volume":"42","author":"Beitler","year":"2016","journal-title":"Intensive Care Med"},{"key":"2026020402580383000_bib12","volume-title":"Premier Perspective hospital database","author":"Premier Research Services"},{"key":"2026020402580383000_bib13","doi-asserted-by":"crossref","first-page":"965","DOI":"10.1164\/ajrccm.152.3.7663811","article-title":"Incidence of the adult respiratory distress syndrome in the state of Utah","volume":"152","author":"Thomsen","year":"1995","journal-title":"Am J Respir Crit Care Med"},{"key":"2026020402580383000_bib14","first-page":"A592","article-title":"What\u2019s the incidence and mortality of ARDS in the US? [abstract]","volume":"153","author":"Angus","year":"1996","journal-title":"Am J Respir Crit Care Med"},{"key":"2026020402580383000_bib15","doi-asserted-by":"crossref","first-page":"29","DOI":"10.1186\/cc121","article-title":"Acute respiratory distress syndrome: estimated incidence and mortality rate in a 5 million-person population base","volume":"2","author":"Reynolds","year":"1998","journal-title":"Crit Care"},{"key":"2026020402580383000_bib16","first-page":"2526","article-title":"Acute respiratory distress syndrome: the Berlin Definition","volume":"307","author":"Ranieri","year":"2012","journal-title":"JAMA"},{"key":"2026020402580383000_bib17","doi-asserted-by":"crossref","first-page":"416","DOI":"10.1016\/j.jtcvs.2013.09.033","article-title":"Resource use trends in extracorporeal membrane oxygenation in adults: an analysis of the Nationwide Inpatient Sample 1998\u20132009","volume":"148","author":"Maxell","year":"2014","journal-title":"J Thorac Cardiovasc Surg"},{"key":"2026020402580383000_bib18","volume-title":"Lexi-Drugs","author":"Lexicomp Online"},{"key":"2026020402580383000_bib19","doi-asserted-by":"crossref","first-page":"8","DOI":"10.1097\/00005650-199801000-00004","article-title":"Comorbidity measures for use with administrative data","volume":"36","author":"Elixhauser","year":"1998","journal-title":"Med Care"},{"key":"2026020402580383000_bib20","doi-asserted-by":"crossref","DOI":"10.1007\/978-1-4899-3242-6","volume-title":"Generalized linear models.","author":"McCullagh","year":"1989"},{"key":"2026020402580383000_bib21","doi-asserted-by":"crossref","first-page":"143","DOI":"10.1503\/cmaj.090979","article-title":"Proliferation of prenatal ultrasonography","volume":"182","author":"You","year":"2010","journal-title":"CMAJ"},{"key":"2026020402580383000_bib22","doi-asserted-by":"crossref","first-page":"380","DOI":"10.1161\/CIRCULATIONAHA.105.560466","article-title":"Proliferation of cardiac technology in Canada: a challenge to the sustainability of Medicare","volume":"113","author":"Alter","year":"2006","journal-title":"Circulation"},{"key":"2026020402580383000_bib23","doi-asserted-by":"crossref","first-page":"299","DOI":"10.1046\/j.1365-2710.2002.00430.x","article-title":"Segmented regression analysis of interrupted time series studies in medication use research","volume":"27","author":"Wagner","year":"2002","journal-title":"J Clin Pharm Ther"},{"key":"2026020402580383000_bib24","first-page":"CD002787","article-title":"Inhaled nitric oxide for acute respiratory distress syndrome (ARDS) and acute lung injury in children and adults","volume":"7","author":"Afshari","year":"2010","journal-title":"Cochrane Database Syst Rev"},{"key":"2026020402580383000_bib25","doi-asserted-by":"crossref","first-page":"1107","DOI":"10.1056\/NEJMoa1005372","article-title":"Neuromuscular blockers in early acute respiratory distress syndrome","volume":"363","author":"Papazian","year":"2010","journal-title":"N Engl J Med"},{"key":"2026020402580383000_bib26","doi-asserted-by":"crossref","first-page":"1374","DOI":"10.1164\/rccm.201311-2023OC","article-title":"Predicting survival after extracorporeal membrane oxygenation for severe acute respiratory failure: the Respiratory Extracorporeal Membrane Oxygenation Survival Prediction (RESP) score","volume":"189","author":"Schmidt","year":"2014","journal-title":"Am J Respir Crit Care Med"},{"key":"2026020402580383000_bib27","doi-asserted-by":"crossref","first-page":"423","DOI":"10.1001\/jama.298.4.423","article-title":"Trends in the use of the pulmonary artery catheter in the United States, 1993\u20132004","volume":"298","author":"Wiener","year":"2007","journal-title":"JAMA"},{"key":"2026020402580383000_bib28","doi-asserted-by":"crossref","first-page":"288","DOI":"10.7326\/0003-4819-138-4-200302180-00007","article-title":"The implications of regional variations in Medicare spending. 2. Health outcomes and satisfaction with care","volume":"138","author":"Fisher","year":"2003","journal-title":"Ann Intern Med"},{"key":"2026020402580383000_bib29","doi-asserted-by":"crossref","first-page":"2667","DOI":"10.1097\/CCM.0b013e318298a41e","article-title":"Understanding changes in established practice: pulmonary artery catheter use in critically ill patients","volume":"41","author":"Gershengorn","year":"2013","journal-title":"Crit Care Med"},{"key":"2026020402580383000_bib30","doi-asserted-by":"crossref","first-page":"87","DOI":"10.1186\/1471-2253-14-87","article-title":"Perceptions of diagnosis and management of patients with acute respiratory distress syndrome: a survey of UK intensive care physicians","volume":"14","author":"Dushianthan","year":"2014","journal-title":"BMC Anesthesiol"},{"key":"2026020402580383000_bib31","doi-asserted-by":"crossref","first-page":"277","DOI":"10.1007\/s00101-015-0010-1","article-title":"[Therapy of acute respiratory distress syndrome: survey of German ARDS centers and scientific evidence] [article in German]","volume":"64","author":"Kredel","year":"2015","journal-title":"Anaesthesist"},{"key":"2026020402580383000_bib32","doi-asserted-by":"crossref","first-page":"1322","DOI":"10.1097\/CCM.0b013e3182120829","article-title":"Utilization patterns and patient outcomes associated with use of rescue therapies in acute lung injury","volume":"39","author":"Walkey","year":"2011","journal-title":"Crit Care Med"},{"key":"2026020402580383000_bib33","doi-asserted-by":"crossref","first-page":"172","DOI":"10.1111\/j.1748-720X.1986.tb00974.x","article-title":"Bentham in a box: technology assessment and health care allocation","volume":"14","author":"Jonsen","year":"1986","journal-title":"Law Med Health Care"},{"key":"2026020402580383000_bib34","doi-asserted-by":"crossref","first-page":"1176","DOI":"10.1056\/NEJMe1007136","article-title":"Neuromuscular blocking agents in ARDS","volume":"363","author":"Slutsky","year":"2010","journal-title":"N Engl J Med"},{"key":"2026020402580383000_bib35","doi-asserted-by":"crossref","first-page":"801","DOI":"10.1001\/jamainternmed.2015.0157","article-title":"Effect of published scientific evidence on glycemic control in adult intensive care units","volume":"175","author":"Niven","year":"2015","journal-title":"JAMA Intern Med"},{"key":"2026020402580383000_bib36","first-page":"1442","article-title":"Understanding why we agree on the evidence but disagree on the medicine","volume":"46","author":"Rubenfeld","year":"2001","journal-title":"Respir Care"},{"key":"2026020402580383000_bib37","doi-asserted-by":"crossref","first-page":"1105","DOI":"10.1513\/AnnalsATS.201508-560OC","article-title":"Refractory hypoxemia and use of rescue strategies","volume":"13","author":"Alhurani","year":"2016","journal-title":"Ann Am Thorac Soc"},{"key":"2026020402580383000_bib38","doi-asserted-by":"crossref","first-page":"114","DOI":"10.1016\/j.jcrc.2015.12.007","article-title":"Adoption and de-adoption of drotrecogin alfa for severe sepsis in the United States","volume":"32","author":"Kahn","year":"2016","journal-title":"J Crit Care"},{"key":"2026020402580383000_bib39","doi-asserted-by":"crossref","first-page":"1304","DOI":"10.1164\/rccm.200205-478OC","article-title":"Impact of randomized trial results on acute lung injury ventilator therapy in teaching hospitals","volume":"167","author":"Weinert","year":"2003","journal-title":"Am J Respir Crit Care Med"}],"container-title":["Annals of the American Thoracic Society"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/annalsats\/article-pdf\/14\/1\/94\/66714377\/annalsats_14_1_94.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/annalsats\/article-pdf\/14\/1\/94\/66714377\/annalsats_14_1_94.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,2,4]],"date-time":"2026-02-04T07:58:14Z","timestamp":1770191894000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/annalsats\/article\/14\/1\/94\/8452708"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2017,1,1]]},"references-count":39,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2017,1,1]]},"published-print":{"date-parts":[[2017,1,1]]}},"URL":"https:\/\/doi.org\/10.1513\/annalsats.201606-438oc","relation":{},"ISSN":["2329-6933","2325-6621"],"issn-type":[{"value":"2329-6933","type":"print"},{"value":"2325-6621","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2017,1]]},"published":{"date-parts":[[2017,1,1]]}}}