A randomized controlled trial comparing the ventilation duration between Adaptive Support Ventilation and Pressure Assist/Control Ventilation in medical ICU patients.
Chest. 2015 Mar 5;
Authors: Kirakli C, Naz I, Ediboglu O, Tatar D, Budak A, Tellioglu E
Background: Adaptive support ventilation (ASV) is a closed loop mode of mechanical ventilation (MV) that provides a target minute ventilation by automatically adapting inspiratory pressure and respiratory rate with the minimum work of breathing for the patient. The aim of this study was to determine the effect of ASV on total MV duration when compared to Pressure Assist/Control Ventilation (P-ACV).
Methods: Adult medical patients intubated and mechanically ventilated for more than 24 hours in a medical ICU were randomized either to ASV or P-ACV. Sedation and medical treatment were standardized for each group. Primary outcome was the total MV duration. Secondary outcomes were the weaning duration, number of manual settings of the ventilator and weaning success rates.
Results: Two hundred and twenty nine patients were included. Median MV duration until weaning, weaning and total MV duration were significantly shorter in the ASV group [67 (43-94) vs. 92 (61-165) hours, p= 0.003; 2 (2-2) vs. 2 (2-80) hours, p=0.001 and 4 (2-6) vs 4 (3-9) days, p=0.016 respectively]. Patients in the ASV group required fewer total number of manual settings on the ventilator to reach the desired pH and PaCO2 levels [2 (1-2) vs. 3 (2-5), p<0.001)]. Number of patients successfully extubated on the first attempt was significantly higher in the ASV group (p=0.001). Weaning success and mortality at day 28 were comparable between the two groups.
Conclusions: In medical ICU patients, ASV may shorten the duration of weaning and total MV duration with less number of manual ventilator settings.
Clinical trial registration: ClinicalTrials.gov Identifier: NCT01472302.
PMID: 25742308 [PubMed - as supplied by publisher]