Smart Mode of Mechanical Lung Ventilation During Early Activation of Cardiosurgical Patients
Purpose of the study: a comparative assessment of safety and quality of respiratory support carried out using the ASV mode vs. conventional protocol, in which ventilation parameters are set by an ICU physician during early postoperative period in cardiosurgical patients.Materials and methods. The mo...
| Main Authors: | , |
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| Format: | Article |
| Language: | English |
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Federal Research and Clinical Center of Intensive Care Medicine and Rehabilitology, Moscow, Russia
2020-03-01
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| Series: | Общая реаниматология |
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| Online Access: | https://www.reanimatology.com/rmt/article/view/1850 |
| _version_ | 1797874221510033408 |
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| author | A. A. Eremenko R. D. Komnov |
| author_facet | A. A. Eremenko R. D. Komnov |
| author_sort | A. A. Eremenko |
| collection | DOAJ |
| description | Purpose of the study: a comparative assessment of safety and quality of respiratory support carried out using the ASV mode vs. conventional protocol, in which ventilation parameters are set by an ICU physician during early postoperative period in cardiosurgical patients.Materials and methods. The modes of a respiratory support included automated ASV ventilation (40 patients) versus conventional ventilation (38 patients) managed by 8 ICU physicians were compared in a cohort of cardiosurgical patients in a randomized controlled study.The comparison included ventilation parameters, all efforts of physicians to adjust ventilator settings and time it took, duration of respiratory support in ICU, incidence of adverse events in the course of weaning, total time in ICU and hospital, postoperative complications and mortality.Results. There was no reliable difference in the duration of postoperative trachea intubation, which was equal to 267±76 minutes (the ASV group) and 271±80 minutes (the control group).The number of manual adjustments, which was 2 vs. 4 (P<0.00001), and the time spent by a clinical physician near a ventilator, which was 99±35 seconds vs. 166±70 seconds, were reliably lower in the ASV group (P=0.00001).The time between restoration of patient’s own respiratory activity and transfer to the assisted breathing mode was longer in the control group and amounted to 30 (0–90) min. while in the smart mode, the transfer took place immediately after restoration (P=0.004969).When ASV was used, the driving pressure was reliably lower during all phases of respiratory support: ΔP 7.2±1.6 vs. 9.3±2.1 cm H2O, (P=0.000001); there was no reliable difference in the tidal volume: 7.0 (6–8.5) (ASV) vs. 7 (6–10) ml/kg/ideal body mass (the control group).Conclusion. ASV represents a lung-protective ventilation that reduces physician’s time cost and medical staff efforts in ALV management without compromising patient’s safety and respiratory support quality. |
| first_indexed | 2024-04-10T01:27:28Z |
| format | Article |
| id | doaj.art-b138b11822fc4462823d3ab59fac5f86 |
| institution | Directory Open Access Journal |
| issn | 1813-9779 2411-7110 |
| language | English |
| last_indexed | 2024-04-10T01:27:28Z |
| publishDate | 2020-03-01 |
| publisher | Federal Research and Clinical Center of Intensive Care Medicine and Rehabilitology, Moscow, Russia |
| record_format | Article |
| series | Общая реаниматология |
| spelling | doaj.art-b138b11822fc4462823d3ab59fac5f862023-03-13T09:32:56ZengFederal Research and Clinical Center of Intensive Care Medicine and Rehabilitology, Moscow, RussiaОбщая реаниматология1813-97792411-71102020-03-0116141510.15360/1813-9779-2020-1-4-151721Smart Mode of Mechanical Lung Ventilation During Early Activation of Cardiosurgical PatientsA. A. Eremenko0R. D. Komnov1Российский научный центр хирургии им. акад. Б. В. ПетровскогоРоссийский научный центр хирургии им. акад. Б. В. ПетровскогоPurpose of the study: a comparative assessment of safety and quality of respiratory support carried out using the ASV mode vs. conventional protocol, in which ventilation parameters are set by an ICU physician during early postoperative period in cardiosurgical patients.Materials and methods. The modes of a respiratory support included automated ASV ventilation (40 patients) versus conventional ventilation (38 patients) managed by 8 ICU physicians were compared in a cohort of cardiosurgical patients in a randomized controlled study.The comparison included ventilation parameters, all efforts of physicians to adjust ventilator settings and time it took, duration of respiratory support in ICU, incidence of adverse events in the course of weaning, total time in ICU and hospital, postoperative complications and mortality.Results. There was no reliable difference in the duration of postoperative trachea intubation, which was equal to 267±76 minutes (the ASV group) and 271±80 minutes (the control group).The number of manual adjustments, which was 2 vs. 4 (P<0.00001), and the time spent by a clinical physician near a ventilator, which was 99±35 seconds vs. 166±70 seconds, were reliably lower in the ASV group (P=0.00001).The time between restoration of patient’s own respiratory activity and transfer to the assisted breathing mode was longer in the control group and amounted to 30 (0–90) min. while in the smart mode, the transfer took place immediately after restoration (P=0.004969).When ASV was used, the driving pressure was reliably lower during all phases of respiratory support: ΔP 7.2±1.6 vs. 9.3±2.1 cm H2O, (P=0.000001); there was no reliable difference in the tidal volume: 7.0 (6–8.5) (ASV) vs. 7 (6–10) ml/kg/ideal body mass (the control group).Conclusion. ASV represents a lung-protective ventilation that reduces physician’s time cost and medical staff efforts in ALV management without compromising patient’s safety and respiratory support quality.https://www.reanimatology.com/rmt/article/view/1850адаптивная поддерживающая вентиляцияинтеллектуальный режим вентиляциикардиохирургияинтенсивная терапия |
| spellingShingle | A. A. Eremenko R. D. Komnov Smart Mode of Mechanical Lung Ventilation During Early Activation of Cardiosurgical Patients Общая реаниматология адаптивная поддерживающая вентиляция интеллектуальный режим вентиляции кардиохирургия интенсивная терапия |
| title | Smart Mode of Mechanical Lung Ventilation During Early Activation of Cardiosurgical Patients |
| title_full | Smart Mode of Mechanical Lung Ventilation During Early Activation of Cardiosurgical Patients |
| title_fullStr | Smart Mode of Mechanical Lung Ventilation During Early Activation of Cardiosurgical Patients |
| title_full_unstemmed | Smart Mode of Mechanical Lung Ventilation During Early Activation of Cardiosurgical Patients |
| title_short | Smart Mode of Mechanical Lung Ventilation During Early Activation of Cardiosurgical Patients |
| title_sort | smart mode of mechanical lung ventilation during early activation of cardiosurgical patients |
| topic | адаптивная поддерживающая вентиляция интеллектуальный режим вентиляции кардиохирургия интенсивная терапия |
| url | https://www.reanimatology.com/rmt/article/view/1850 |
| work_keys_str_mv | AT aaeremenko smartmodeofmechanicallungventilationduringearlyactivationofcardiosurgicalpatients AT rdkomnov smartmodeofmechanicallungventilationduringearlyactivationofcardiosurgicalpatients |