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

Détails

ID Serval
serval:BIB_5ECB18E5A7D1
Type
Article: article d'un périodique ou d'un magazine.
Collection
Publications
Institution
Titre
Automatic "respirator/weaning" with adaptive support ventilation: the effect on duration of endotracheal intubation and patient management
Périodique
Anesthesia and Analgesia
Auteur(s)
Petter  A. H., Chiolero  R. L., Cassina  T., Chassot  P. G., Muller  X. M., Revelly  J. P.
ISSN
0003-2999 (Print)
Statut éditorial
Publié
Date de publication
12/2003
Volume
97
Numéro
6
Pages
1743-50
Notes
Clinical Trial
Journal Article
Randomized Controlled Trial
Research Support, Non-U.S. Gov't --- Old month value: Dec
Résumé
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.
Mots-clé
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
Création de la notice
24/01/2008 18:03
Dernière modification de la notice
20/08/2019 15:16
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