2 research outputs found
Comparison of Mechanical Power During Adaptive Support Ventilation Versus Nonautomated Pressure-Controlled Ventilation-A Pilot Study
Objectives: The aim of this pilot study was to compare the amount of "mechanical power of ventilation" under adaptive support ventilation with nonautomated pressure-controlled ventilation. Design: Single-center, observational prospective pilot study adjoining unitwide implementation of adaptive support ventilation in our department. Setting: The ICU of a nonacademic teaching hospital in the Netherlands. Patients: Twenty-four passive invasively ventilated critically ill patients expected to need of invasive ventilation beyond the following calendar day. Measurements and Main Results: In patients under adaptive support ventilation, only positive end-expiratory pressure and Fio2 were set by the caregivers-all other ventilator settings were under control of the ventilator; in patients under pressure-controlled ventilation, maximum airway pressure (Pmax), positive end-expiratory pressure, Fio2, and respiratory rate were set by the caregivers. Mechanical power of ventilation was calculated three times per day. Compared with pressure-controlled ventilation, mechanical power of ventilation with adaptive support ventilation was lower (15.1 [10.5-25.7] vs 22.9 [18.7-28.8] J/min; p = 0.04). Tidal volume was not different, but Pmax (p = 0.012) and respiratory rate (p = 0.012) were lower with adaptive support ventilation. Conclusions: This study suggests adaptive support ventilation may have benefits compared with pressure-controlled ventilation with respect to the mechanical power of ventilation transferred from the ventilator to the respiratory system in passive invasively ventilated critically ill patients. The difference in mechanical power of ventilation is not a result of a difference in tidal volume, but the reduction in applied pressures and respiratory rate. The findings of this observational pilot study need to be confirmed in a larger, preferably randomized clinical trial
Effect of intelliventāasv versus conventional ventilation on ventilation intensity in patients with covidā19 ardsā an observational study
Driving pressure (ĪP) and mechanical power (MP) are associated with outcomes in critically ill patients, irrespective of the presence of Acute Respiratory Distress Syndrome (ARDS). INTELLiVENTāASV, a fully automated ventilatory mode, controls the settings that affect ĪP and MP. This study compared the intensity of ventilation (ĪP and MP) with INTELLiVENTāASV versus conventional ventilation in a cohort of COVIDā19 ARDS patients in two intensive care units in the Netherlands. The coprimary endpoints were ĪP and MP before and after converting from conventional ventilation to INTELLiVENTāASV. Compared to conventional ventilation, INTELLiVENTāASV delivered ventilation with a lower ĪP and less MP. With conventional ventilation, ĪP was 13 cmH2O, and MP was 21.5 and 24.8 J/min, whereas with INTELLiVENTāASV, ĪP was 11 and 10 cmH2O (mean difference ā2 cm H2O (95 %CI ā2.5 to ā1.2 cm H2O), p < 0.001) and MP was 18.8 and 17.5 J/min (mean difference ā7.3 J/Min (95% CI ā8.8 to ā5.8 J/min), p < 0.001). Conversion from conventional ventilation to INTELLiVENTāASV resulted in a lower intensity of ventilation. These findings may favor the use of INTELLiVENTāASV in COVIDā19 ARDS patients, but future studies remain needed to see if the reduction in the intensity of ventilation translates into clinical benefits