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- Title
Safety and efficacy of a fully closed-loop control ventilation (IntelliVent-ASV) in sedated ICU patients with acute respiratory failure: a prospective randomized crossover study.
- Authors
Arnal, Jean-Michel; Wysocki, Marc; Novotni, Dominik; Demory, Didier; Lopez, Ricardo; Donati, Stéphane; Granier, Isabelle; Corno, Gaëlle; Durand-Gasselin, Jacques
- Abstract
Purpose: IntelliVent-ASV is a development of adaptive support ventilation (ASV) that automatically adjusts ventilation and oxygenation parameters. This study assessed the safety and efficacy of IntelliVent-ASV in sedated intensive care unit (ICU) patients with acute respiratory failure. Methods: This prospective randomized crossover comparative study was conducted in a 12-bed ICU in a general hospital. Two periods of 2 h of ventilation in randomly applied ASV or IntelliVent-ASV were compared in 50 sedated, passively ventilated patients. Tidal volume ( V), respiratory rate (RR), inspiratory pressure ( P), SpO and ECO were continuously monitored and recorded breath by breath. Mean values over the 2-h period were calculated. Respiratory mechanics, plateau pressure ( P) and blood gas exchanges were measured at the end of each period. Results: There was no safety issue requiring premature interruption of IntelliVent-ASV. Minute ventilation (MV) and V decreased from 7.6 (6.5-9.5) to 6.8 (6.0-8.0) L/min ( p < 0.001) and from 8.3 (7.8-9.0) to 8.1 (7.7-8.6) mL/kg PBW ( p = 0.003) during IntelliVent-ASV as compared to ASV. P and FiO decreased from 24 (20-29) to 20 (19-25) cmHO ( p = 0.005) and from 40 (30-50) to 30 (30-39) % ( p < 0.001) during IntelliVent-ASV as compared to ASV. RR, P, and PEEP decreased as well during IntelliVent-ASV as compared to ASV. Respiratory mechanics, pH, PaO and PaO/FiO ratio were not different but PaCO was slightly higher during IntelliVent-ASV as compared to ASV. Conclusions: In passive patients with acute respiratory failure, IntelliVent-ASV was safe and able to ventilate patients with less pressure, volume and FiO while producing the same results in terms of oxygenation.
- Subjects
RESPIRATORY insufficiency; CRITICAL care medicine; INTENSIVE care units; ARTIFICIAL respiration; RESPIRATORY therapy; RESUSCITATION
- Publication
Intensive Care Medicine, 2012, Vol 38, Issue 5, p781
- ISSN
0342-4642
- Publication type
Article
- DOI
10.1007/s00134-012-2548-6