Use of an Automated Ventilation Mode in Chronic Obstructive Pulmonary Disease: A Randomized Controlled Trial

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Cinleti B. A., Gursan I. N., Yavuz T., YILDIRIM S., ÖZKARAKAŞ H., Kirakli C.

Journal of Critical and Intensive Care, cilt.15, sa.1, ss.16-22, 2024 (ESCI, Scopus, TRDizin)

  • Yayın Türü: Makale / Tam Makale
  • Cilt numarası: 15 Sayı: 1
  • Basım Tarihi: 2024
  • Doi Numarası: 10.14744/dcybd.2023.3638
  • Dergi Adı: Journal of Critical and Intensive Care
  • Derginin Tarandığı İndeksler: Emerging Sources Citation Index (ESCI), Scopus, TR DİZİN (ULAKBİM)
  • Sayfa Sayıları: ss.16-22
  • Anahtar Kelimeler: Closed-loop ventilation, COPD, Mechanical ventilation, Prolonged mechanical ventilation, Weaning
  • Açık Arşiv Koleksiyonu: AVESİS Açık Erişim Koleksiyonu
  • Sağlık Bilimleri Üniversitesi Adresli: Evet

Özet

Aim: Prolonged mechanical ventilation is a clinical condition that leads to higher complication rates and a longer stay in the intensive care unit (ICU). Shortening the duration of mechanical ventilation is one of the main goals of intensive care. In this study, we aim to evaluate a fully closed-loop mode, INTELLiVENT®-ASV® (Intelligent Ventilation-Adaptive Support Ventilation), in ventilating chronic obstructive pulmonary disease (COPD) patients in terms of ventilation duration and workload of clinicians compared with a conventional mode. Study Design: This is a randomized controlled study performed in a 23-bed medical ICU. COPD patients who were followed up on invasive mechanical ventilation (IMV) were randomized into INTELLiVENT®-ASV® or P-ACV (Pressure-Assisted Controlled Ventilation) groups. Ventilation data were recorded with dedicated software connected to the ventilator. The duration of mechanical ventilation and weaning, the number of manual and automatic settings of the ventilator, and other clinical endpoints were compared between the two groups. Results: IMV duration was found to be lower in the INTELLiVENT®-ASV® group [1.9 (1.0-3.8) days vs. 3.0 (1.9-5.2) days, p=0.02]. The number of manual changes to ventilator settings and arterial blood gas analyses per day were significantly lower in the INTELLiVENT®-ASV® group than in the P-ACV group [1.2 (0.2-1.7) vs. 6.8 (4.6-8.2), p<0.001, and 1.38 (1.03-2.06) vs. 2.09 (1.58-7.74), p<0.05, respectively]. Conclusions: The use of closed-loop mechanical ventilation may reduce IMV duration and the workload of clinicians and respiratory therapists.