Ispol'zovanie rezhima IntelliVent-ASV dlia podderzhaniia tselevogo diapazona EtCO2 u patsientov s tiazheloĭ ChMT [Use of the IntelliVent-ASV mode for maintaining the target EtCO2 range in patients with severe TBI]

Détails

ID Serval
serval:BIB_350994E454E3
Type
Article: article d'un périodique ou d'un magazine.
Collection
Publications
Institution
Titre
Ispol'zovanie rezhima IntelliVent-ASV dlia podderzhaniia tselevogo diapazona EtCO2 u patsientov s tiazheloĭ ChMT [Use of the IntelliVent-ASV mode for maintaining the target EtCO2 range in patients with severe TBI]
Périodique
Zhurnal voprosy neirokhirurgii imeni N. N. Burdenko
Auteur(s)
Anan'ev E.P., Polupan A.A., Matskovskiy I.V., Oshorov A.V., Goryachev A.S., Savin I.A., Sychev A.A., Tabasaranskiy T.F., Podlepich V.V., Krylov K.Y., Pashin A.A., Satishur O.E., Piquilloud L., Novotni D., Potapov A.A., Savchenko Y.V.
ISSN
0042-8817 (Print)
ISSN-L
0042-8817
Statut éditorial
Publié
Date de publication
2017
Peer-reviewed
Oui
Volume
81
Numéro
5
Pages
63-68
Langue
russe
Notes
Publication types: Journal Article
Publication Status: ppublish
Résumé
the study purpose was to evaluate the efficacy of the IntelliVent-ASV mode in maintaining the target range of PaCO2 in patients with severe TBI.
The study included 12 severe TBI patients with the wakefulness level scored 4-9 (GCS). This was a crossover design study. Two ventilation modes were consecutively used: IntelliVent-ASV and P-CMV, for 12 h each. When using the P-CMV mode, the ventilation parameters were set to maintain PaCO2 in a range of 35-38 mm Hg. The IntelliVent-ASV mode involved the Brain Injury ventilation algorithm. The target range of EtCO2 was set in accordance with the delta PaCO2-EtCO2 to maintain PaCO2 in a range of 35-38. At the beginning of each ventilation period and every 3 hours, the arterial blood gas composition was analyzed. When PaCO2 occurred out of the 35-38 range, appropriate adjustments were made to the ventilation parameters. In the P-CMV mode, the Pinsp and RR parameters were adjusted to achieve the target PaCO2 range. In IntelliVent mode, a shift of the target EtCO2 range was adjusted in accordance with a changed PaCO2-EtCO2 difference. In all patients, ICP, blood pressure, and EtCO2 were monitored; the arterial blood gas composition was analyzed every 3 h; the frequency of manual settings of ventilation parameters was recorded.
The EtCO2 and PaCO2 parameters were found not to be significantly different in the P-CMV and IntelliVent modes, but the spread in these parameters was significantly lower in the IntelliVent ventilation mode. The PaCO2 parameter occurred out of the target range significantly less often in the IntelliVent mode than in the P-CMV mode. The mean frequency of manual respirator settings needed to maintain the target EtCO2 range was significantly lower in the IntelliVent-ASV mode than in the P-CMV mode.
The IntelliVent-ASV mode provides more efficient maintenance of PaCO2 in the target range compared to traditional artificial ventilation using fewer manual settings of the ventilation parameters.

Mots-clé
Adult, Algorithms, Blood Gas Analysis/methods, Brain Injuries, Traumatic/blood, Brain Injuries, Traumatic/therapy, Carbon Dioxide/blood, Female, Humans, Male, Middle Aged, Respiration, Artificial/instrumentation, Respiration, Artificial/methods, IntelliVent-ASV, artificial ventilation, traumatic brain injury
Pubmed
Open Access
Oui
Création de la notice
09/11/2017 19:37
Dernière modification de la notice
20/08/2019 14:22
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