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Comparison of Mechanical Power During Adaptive Support Ventilation Versus Nonautomated Pressure-Controlled Ventilation-A Pilot Study.

التفاصيل البيبلوغرافية
العنوان: Comparison of Mechanical Power During Adaptive Support Ventilation Versus Nonautomated Pressure-Controlled Ventilation-A Pilot Study.
المؤلفون: Buiteman-Kruizinga LA; Department of Intensive Care, Reinier de Graaf Hospital, Delft, the Netherlands., Mkadmi HE; Department of Research, Reinier de Graaf Hospital, Delft, the Netherlands., Schultz MJ; Department of Intensive Care, Academic Medical Center, Amsterdam, the Netherlands.; Laboratory of Experimental Intensive Care and Anesthesiology (L·E·I·C·A), Academic Medical Center, Amsterdam, the Netherlands.; Mahidol-Oxford Tropical Medicine Research Unit (MORU), Mahidol University, Bangkok, Thailand.; Nuffield Department of Medicine, University of Oxford, Oxford, United Kingdom., Tangkau PL; Department of Intensive Care, Reinier de Graaf Hospital, Delft, the Netherlands., van der Heiden PLJ; Department of Intensive Care, Reinier de Graaf Hospital, Delft, the Netherlands.
المصدر: Critical care explorations [Crit Care Explor] 2021 Feb 15; Vol. 3 (2), pp. e0335. Date of Electronic Publication: 2021 Feb 15 (Print Publication: 2021).
نوع المنشور: Journal Article
اللغة: English
بيانات الدورية: Publisher: Wolters Kluwer Health Country of Publication: United States NLM ID: 101746347 Publication Model: eCollection Cited Medium: Internet ISSN: 2639-8028 (Electronic) Linking ISSN: 26398028 NLM ISO Abbreviation: Crit Care Explor Subsets: PubMed not MEDLINE
أسماء مطبوعة: Original Publication: Philadelphia, PA : Wolters Kluwer Health, [2019]-
مستخلص: 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 Fio 2 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, Fio 2 , 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.
Competing Interests: Dr. Schultz attended a workshop organized by Hamilton, expenses for lodging was covered for the invited experts, and participants from abroad had their travel expenses reimbursed and speakers received a speaker’s fee of CHF 800. The remaining authors have disclosed that they do not have any potential conflicts of interest.
(Copyright © 2021 The Authors. Published by Wolters Kluwer Health, Inc. on behalf of the Society of Critical Care Medicine.)
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فهرسة مساهمة: Keywords: closed-loop ventilation; critical care medicine; mechanical power; mechanical ventilation
تواريخ الأحداث: Date Created: 20210219 Latest Revision: 20220420
رمز التحديث: 20221213
مُعرف محوري في PubMed: PMC7886404
DOI: 10.1097/CCE.0000000000000335
PMID: 33604578
قاعدة البيانات: MEDLINE
الوصف
تدمد:2639-8028
DOI:10.1097/CCE.0000000000000335