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01.05.2012 | Original

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

verfasst von: Jean-Michel Arnal, Marc Wysocki, Dominik Novotni, Didier Demory, Ricardo Lopez, Stéphane Donati, Isabelle Granier, Gaëlle Corno, Jacques Durand-Gasselin

Erschienen in: Intensive Care Medicine | Ausgabe 5/2012

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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 _T), respiratory rate (RR), inspiratory pressure (P _INSP), SpO₂ and E_TCO₂ were continuously monitored and recorded breath by breath. Mean values over the 2-h period were calculated. Respiratory mechanics, plateau pressure (P _PLAT) 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 _T 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 _PLAT and FiO₂ decreased from 24 (20–29) to 20 (19–25) cmH₂O (p = 0.005) and from 40 (30–50) to 30 (30–39) % (p < 0.001) during IntelliVent-ASV^® as compared to ASV. RR, P _INSP, and PEEP decreased as well during IntelliVent-ASV^® as compared to ASV. Respiratory mechanics, pH, PaO₂ and PaO₂/FiO₂ ratio were not different but PaCO₂ 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 FiO₂ while producing the same results in terms of oxygenation.

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Titel: 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
verfasst von: Jean-Michel Arnal
Marc Wysocki
Dominik Novotni
Didier Demory
Ricardo Lopez
Stéphane Donati
Isabelle Granier
Gaëlle Corno
Jacques Durand-Gasselin
Publikationsdatum: 01.05.2012
Verlag: Springer-Verlag
Erschienen in: Intensive Care Medicine / Ausgabe 5/2012
Print ISSN: 0342-4642
Elektronische ISSN: 1432-1238
DOI: https://doi.org/10.1007/s00134-012-2548-6

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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