Automatic "respirator/weaning" with adaptive support ventilation: the effect on duration of endotracheal intubation and patient management

Details

Serval ID
serval:BIB_5ECB18E5A7D1
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Automatic "respirator/weaning" with adaptive support ventilation: the effect on duration of endotracheal intubation and patient management
Journal
Anesthesia and Analgesia
Author(s)
Petter  A. H., Chiolero  R. L., Cassina  T., Chassot  P. G., Muller  X. M., Revelly  J. P.
ISSN
0003-2999 (Print)
Publication state
Published
Issued date
12/2003
Volume
97
Number
6
Pages
1743-50
Notes
Clinical Trial
Journal Article
Randomized Controlled Trial
Research Support, Non-U.S. Gov't --- Old month value: Dec
Abstract
Adaptive support ventilation (ASV) provides an automatic adaptation of the ventilator settings to patient's passive and active respiratory mechanics. In a randomized controlled study, we evaluated automatic respiratory weaning in ASV for early tracheal extubation after cardiac surgery. Eligible patients were assigned to either an ASV protocol or a standard one consisting of synchronized intermittent ventilation followed by pressure support. Eighteen patients completed the ASV protocol, and 16 completed the standard one. There were no differences between groups in perioperative characteristics, lengths of tracheal intubation and intensive care unit stay, and ventilatory variables, except less peak inspiratory pressure during the initial phase in ASV (17.5 +/- 0.8 versus 22.2 +/- 0.8 cm H(2)O; P < 0.01). ASV patients required fewer ventilatory settings manipulations (2.4 +/- 0.7 versus 4.0 +/- 0.8 manipulations per patient; P < 0.05) and endured less high-inspiratory pressure alarms (0.7 +/- 2.4 versus 2.9 +/- 3.0; P < 0.05). These results suggest that in this specific population of patients, automation of postoperative ventilation with ASV resulted in an outcome similar to the control group. The internal logic of the new device resulted in less manipulation of the setting and alarms that could simplify respiratory management. IMPLICATIONS: Adaptive support ventilation (ASV), a ventilatory mode providing automatic adjustment of the settings was compared with standard management for rapid tracheal extubation after cardiac surgery. The two approaches were equal in terms of outcome. In ASV, we observed fewer ventilator settings manipulations and a smaller amount of alarms, suggesting that this automatic mode may simplify postoperative respiratory management without delaying extubation.
Keywords
Aged Blood Gas Analysis Clinical Protocols Female Humans *Intubation, Intratracheal Male Middle Aged Patient Care Management Respiration, Artificial/*methods Respiratory Insufficiency/therapy Respiratory Mechanics/physiology Tidal Volume/physiology Ventilator Weaning/adverse effects/*methods
Pubmed
Web of science
Create date
24/01/2008 17:03
Last modification date
20/08/2019 14:16
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