The Efficacy and Safety of Automatic Modes During Respiratory Support After Cardiac Surgery
Aims. To compare the efficacy and safety of semiautonomous Adaptive Support Ventilation (ASV) and fully automated (closed-loop, Intellivent-ASV) mechanical ventilation and oxygenation versus conventional mechanical ventilation mode during respiratory support in cardiac surgery patients.Material and me...
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Federal Research and Clinical Center of Intensive Care Medicine and Rehabilitology, Moscow, Russia
2022-06-01
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| Series: | Общая реаниматология |
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| Online Access: | https://www.reanimatology.com/rmt/article/view/2236 |
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| author | A. A. Yeremenko R. D. Komnov E. A. Koshek |
| author_facet | A. A. Yeremenko R. D. Komnov E. A. Koshek |
| author_sort | A. A. Yeremenko |
| collection | DOAJ |
| description | Aims. To compare the efficacy and safety of semiautonomous Adaptive Support Ventilation (ASV) and fully automated (closed-loop, Intellivent-ASV) mechanical ventilation and oxygenation versus conventional mechanical ventilation mode during respiratory support in cardiac surgery patients.Material and methods. In this study, 40 adult patients were ventilated by conventional mechanical ventilation managed by 8 physicians (control group), whereas other two groups patients were ventilated by Intellivent-ASV (n=40) or in a semiautomatic ASV mode (n=40). The groups received standard care, except for the modes of ventilation.Results. In the Intellivent-ASV group, the number of manual changes in ventilator settings was significantly lower: 0 (0–0) versus 2 (2–3) (ASV) and 4 (3–5) in the control group (P<0.0001). There were significant differences in the duration of respiratory support in ICU which was 226±31 min (Intellivent group) vs 259±66 (ASV) and 271±78 min (control) (P=0.0042; P1–2=0.0167; P1–3=0.009). The Intellivent-ASV group patients received more protective ventilation than patients in the semiautomated and physician-controlled groups (lower values of driving pressure (6 (6–7) cm H2O vs. 6 (6–7) and 7 (7–9) cm H2O (P<0.0001)), tidal volume (6 (6–7) vs. 7 (7–7.7) and 7 (7–8) ml/kg/PBW (P<0.0001)), FiO2 (26 (24–30)% vs. 34 (30–35)% and 34 (30–38)%) with no differences between the groups in paO2/FiO2. There were no significant differences between the groups in frequency of undesirable events and duration of ICU stay.Conclusion. The use of intelligent technologies makes it possible to interactively individualize respiratory support, significantly reducing clinician's involvement in this process without compromising patient safety and the quality of ventilation. |
| format | Article |
| id | doaj-art-f11d2da7f0d04dbf8e98f48c78bc4630 |
| institution | Kabale University |
| issn | 1813-9779 2411-7110 |
| language | English |
| publishDate | 2022-06-01 |
| publisher | Federal Research and Clinical Center of Intensive Care Medicine and Rehabilitology, Moscow, Russia |
| record_format | Article |
| series | Общая реаниматология |
| spelling | doaj-art-f11d2da7f0d04dbf8e98f48c78bc46302025-08-20T03:35:08ZengFederal Research and Clinical Center of Intensive Care Medicine and Rehabilitology, Moscow, RussiaОбщая реаниматология1813-97792411-71102022-06-01183212910.15360/1813-9779-2022-3-21-291849The Efficacy and Safety of Automatic Modes During Respiratory Support After Cardiac SurgeryA. A. Yeremenko0R. D. Komnov1E. A. Koshek2B.V. Petrovsky Russian Research Center for SurgeryB.V. Petrovsky Russian Research Center for SurgeryB.V. Petrovsky Russian Research Center for SurgeryAims. To compare the efficacy and safety of semiautonomous Adaptive Support Ventilation (ASV) and fully automated (closed-loop, Intellivent-ASV) mechanical ventilation and oxygenation versus conventional mechanical ventilation mode during respiratory support in cardiac surgery patients.Material and methods. In this study, 40 adult patients were ventilated by conventional mechanical ventilation managed by 8 physicians (control group), whereas other two groups patients were ventilated by Intellivent-ASV (n=40) or in a semiautomatic ASV mode (n=40). The groups received standard care, except for the modes of ventilation.Results. In the Intellivent-ASV group, the number of manual changes in ventilator settings was significantly lower: 0 (0–0) versus 2 (2–3) (ASV) and 4 (3–5) in the control group (P<0.0001). There were significant differences in the duration of respiratory support in ICU which was 226±31 min (Intellivent group) vs 259±66 (ASV) and 271±78 min (control) (P=0.0042; P1–2=0.0167; P1–3=0.009). The Intellivent-ASV group patients received more protective ventilation than patients in the semiautomated and physician-controlled groups (lower values of driving pressure (6 (6–7) cm H2O vs. 6 (6–7) and 7 (7–9) cm H2O (P<0.0001)), tidal volume (6 (6–7) vs. 7 (7–7.7) and 7 (7–8) ml/kg/PBW (P<0.0001)), FiO2 (26 (24–30)% vs. 34 (30–35)% and 34 (30–38)%) with no differences between the groups in paO2/FiO2. There were no significant differences between the groups in frequency of undesirable events and duration of ICU stay.Conclusion. The use of intelligent technologies makes it possible to interactively individualize respiratory support, significantly reducing clinician's involvement in this process without compromising patient safety and the quality of ventilation.https://www.reanimatology.com/rmt/article/view/2236automatic weaningintellivent-asvintellectual modes of ventilationasvcardiac surgeryintensive care |
| spellingShingle | A. A. Yeremenko R. D. Komnov E. A. Koshek The Efficacy and Safety of Automatic Modes During Respiratory Support After Cardiac Surgery Общая реаниматология automatic weaning intellivent-asv intellectual modes of ventilation asv cardiac surgery intensive care |
| title | The Efficacy and Safety of Automatic Modes During Respiratory Support After Cardiac Surgery |
| title_full | The Efficacy and Safety of Automatic Modes During Respiratory Support After Cardiac Surgery |
| title_fullStr | The Efficacy and Safety of Automatic Modes During Respiratory Support After Cardiac Surgery |
| title_full_unstemmed | The Efficacy and Safety of Automatic Modes During Respiratory Support After Cardiac Surgery |
| title_short | The Efficacy and Safety of Automatic Modes During Respiratory Support After Cardiac Surgery |
| title_sort | efficacy and safety of automatic modes during respiratory support after cardiac surgery |
| topic | automatic weaning intellivent-asv intellectual modes of ventilation asv cardiac surgery intensive care |
| url | https://www.reanimatology.com/rmt/article/view/2236 |
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