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Over the past decade, aerosol therapy during respiratory support has evolved through technological innovations, increasing use of non-invasive respiratory support, novel inhaled therapies, and international expert recommendations. However, how these developments have been translated into contemporary clinical practice remains largely unknown. ICUNEB aims to generate robust international real-world evidence to improve our understanding of current practice and support future research, education, and evidence-informed clinical practice.

Primary descriptive objective
•    Determine the prevalence of aerosol therapy administration among patients receiving respiratory support during the 14-day observation period, reported separately for IMV, NIV and HFNC.

Secondary descriptive objectives
•    Identify the clinical indications for aerosol therapy during IMV, NIV and HFNC.
•    Characterize the inhaled medications administered and their dosing regimens, including dose and administration frequency.
•    Describe the aerosol administration techniques used during IMV, NIV and HFNC, and assess adherence of reported administration practices to current international recommendations, separately for each respiratory support modality.

This project is supported by the European Society of Intensive Care Medicine.

What does participation involve?
Each participating center will prospectively screen consecutive adult patients receiving IMV, NIV, or HFNC during a single 14-day observation period using a secure REDCap® electronic case report form. Core data will be collected for all included patients, with detailed information on inhaled medication, indication, dosing regimen, and administration technique collected for patients receiving aerosol therapy. The study is strictly observational and does not modify usual patient care. Centers may freely select their 14-day observation period within the study window, currently planned from September to December 2027.

Ethics approval for Swiss centres
For Swiss centres, the ICUNEB coordinating team will prepare and coordinate the initial Swiss multicentre ethics submission. Participating centres will only be asked to provide the site-specific information, documents, and signatures required for their centre. Ethics committee fees associated with this initial Swiss multicentre submission will be covered by the ICUNEB study funding.

Interested in participating?