Standardising Terminology, Classification, Diagnostic Recognition and Reporting of Patient-ventilator Interactions: Protocol for an International Delphi Consensus Study

Patient-ventilator interaction describes how a mechanically ventilated patient's breathing effort aligns with ventilator support. Terminology and classification of abnormal patient-ventilator interaction remain inconsistent across clinical practice, research, and education. The INTERACT study is an international modified Delphi consensus study that will invite multidisciplinary experts to rate and refine statements on terminology, classification, diagnostic recognition, and reporting standards for patient-ventilator interaction. The study aims to develop an internationally agreed glossary, taxonomy, and minimum reporting dataset to improve communication, education, research comparability, and future automated detection systems.

Inclusion Criteria: * At least 10 years of experience managing invasively ventilated adult patients with demonstrated patient-ventilator interaction expertise; or authorship of at least two peer-reviewed publications related to patient-ventilator interaction, asynchrony, waveform analysis, or respiratory monitoring; or participation in at least one regional or international guideline, task force, or consensus process related to mechanical ventilation or patient-ventilator interaction. * Ability to provide electronic informed consent. * Ability to participate in iterative Delphi survey rounds. Exclusion Criteria: * Declines or withdraws electronic informed consent. * Unable to complete Delphi surveys in English. * Does not meet the predefined expertise criteria. * Duplicate representation from the same institution if institutional representation limits are exceeded.