Clinical experience with adaptive support ventilation for fast-track cardiac surgery

Details

Serval ID
serval:BIB_B5D1565A9FF0
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Clinical experience with adaptive support ventilation for fast-track cardiac surgery
Journal
Journal of Cardiothoracic and Vascular Anesthesia
Author(s)
Cassina  T., Chiolero  R., Mauri  R., Revelly  J. P.
ISSN
1053-0770 (Print)
Publication state
Published
Issued date
10/2003
Volume
17
Number
5
Pages
571-5
Notes
Clinical Trial
Comparative Study
Journal Article --- Old month value: Oct
Abstract
OBJECTIVE: To evaluate adaptive support ventilation (ASV), an automatic microprocessor-controlled mode of mechanical ventilation, for the initial ventilatory management in consecutive patients eligible for early extubation after cardiac surgery. DESIGN: Prospective observational study. SETTING: Nonuniversity cardiac center. PARTICIPANTS: One hundred fifty-five consecutive patients eligible for early tracheal extubation after cardiac surgery. INTERVENTIONS: On intensive care unit arrival, patients were ventilated by adaptive support ventilation. This mode provided an automatic selection of initial ventilatory parameters and a continuous adaptation to patient's respiratory activity, guaranteeing that a preset minute ventilation was delivered. Once the patients had recovered sustained spontaneous ventilation, the ventilator was switched manually to pressure support for the terminal part of respiratory weaning followed by extubation. MEASUREMENTS AND MAIN RESULTS: In adaptive support ventilation, all patients could be ventilated satisfactorily except 1; tidal volume was 8.7 +/- 1.4 mL/kg of ideal body weight (mean +/- SD), plateau pressure was 20.3 +/- 3.9 cmH(2)O, and arterial blood gas measurements were satisfactory. One hundred thirty-four patients (86%) were extubated within 6 hours, and intubation time was 3.6 (2.53-4.83) hours (median, [quartiles]). No reintubation because of respiratory failure was required. Adaptive support ventilation was considered easy to use by both the nurses and physicians. CONCLUSIONS: Adaptive support ventilation was used in a group of 155 consecutive patients after fast-track cardiac surgery. This ventilation mode was safe, easy to apply, and allowed rapid extubation in suitable patients. ASV may facilitate postoperative respiratory management.
Keywords
Aged Blood Gas Analysis *Cardiac Surgical Procedures Female Heart Diseases/physiopathology/therapy Humans Inhalation/physiology Intensive Care Units Intubation, Intratracheal Length of Stay Male Middle Aged Postoperative Complications/etiology/physiopathology/therapy Prospective Studies *Respiration, Artificial Tidal Volume/physiology Time Factors Treatment Outcome
Pubmed
Web of science
Create date
24/01/2008 17:03
Last modification date
20/08/2019 15:24
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