Automatic adjustment of pressure support by a computer-driven knowledge-based system during noninvasive ventilation: a feasibility study.
Details
Serval ID
serval:BIB_1CED3927E20D
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Automatic adjustment of pressure support by a computer-driven knowledge-based system during noninvasive ventilation: a feasibility study.
Journal
Intensive Care Medicine
ISSN
0342-4642 (Print)
ISSN-L
0342-4642
Publication state
Published
Issued date
2006
Peer-reviewed
Oui
Volume
32
Number
10
Pages
1523-1528
Language
english
Notes
Publication types: Journal Article ; Research Support, Non-U.S. Gov'tPublication Status: ppublish
Abstract
OBJECTIVE: To evaluate the feasibility of using a knowledge-based system designed to automatically titrate pressure support (PS) to maintain the patient in a "respiratory comfort zone" during noninvasive ventilation (NIV) in patients with acute respiratory failure.
DESIGN AND SETTING: Prospective crossover interventional study in an intensive care unit of a university hospital.
PATIENTS: Twenty patients.
INTERVENTIONS: After initial NIV setting and startup in conventional PS by the chest physiotherapist NIV was continued for 45 min with the automated PS activated.
MEASUREMENTS AND RESULTS: During automated PS minute-volume was maintained constant while respiratory rate decreased significantly from its pre-NIV value (20+/-3 vs. 25+/-3 bpm). There was a trend towards a progressive lowering of dyspnea. In hypercapnic patients PaCO(2) decreased significantly from 61+/-9 to 51+/-2 mmHg, and pH increased significantly from 7.31+/-0.05 to 7.35+/-0.03. Automated PS was well tolerated. Two system malfunctions occurred prompting physiotherapist intervention.
CONCLUSIONS: The results of this feasibility study suggest that the system can be used during NIV in patients with acute respiratory failure. Further studies should now determine whether it can improve patient-ventilator interaction and reduce caregiver workload.
DESIGN AND SETTING: Prospective crossover interventional study in an intensive care unit of a university hospital.
PATIENTS: Twenty patients.
INTERVENTIONS: After initial NIV setting and startup in conventional PS by the chest physiotherapist NIV was continued for 45 min with the automated PS activated.
MEASUREMENTS AND RESULTS: During automated PS minute-volume was maintained constant while respiratory rate decreased significantly from its pre-NIV value (20+/-3 vs. 25+/-3 bpm). There was a trend towards a progressive lowering of dyspnea. In hypercapnic patients PaCO(2) decreased significantly from 61+/-9 to 51+/-2 mmHg, and pH increased significantly from 7.31+/-0.05 to 7.35+/-0.03. Automated PS was well tolerated. Two system malfunctions occurred prompting physiotherapist intervention.
CONCLUSIONS: The results of this feasibility study suggest that the system can be used during NIV in patients with acute respiratory failure. Further studies should now determine whether it can improve patient-ventilator interaction and reduce caregiver workload.
Keywords
Aged, Analysis of Variance, Cross-Over Studies, Feasibility Studies, Female, Humans, Intervention Studies, Male, Pressure, Prospective Studies, Respiration, Artificial/methods, Respiratory Insufficiency/physiopathology, Respiratory Insufficiency/therapy, Respiratory Mechanics, Therapy, Computer-Assisted
Pubmed
Web of science
Create date
27/06/2013 15:27
Last modification date
20/08/2019 13:53
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