Use of an Automated Ventilation Mode in Chronic Obstructive Pulmonary Disease: A Randomized Controlled Trial
1Department of Neurology, Intensive Care Unit, Izmir Democracy University Buca Seyfi Demirsoy Training and Research Hospital, Faculty of Medicine, Izmir, Turkiye
2Intensive Care Unit, University of Health Sciences, Izmir Tepecik Training and Research Hospital, Izmir, Turkiye
3Intensive Care Unit, University of Health Sciences, Izmir Bozyaka Training and Research Hospital, Izmir, Turkiye
4Department of Physiotherapy and Rehabilitation, Izmir Katip Celebi University, Faculty of Health Sciences, Izmir, Turkiye
5Department of Gastroenterology, University of Health Sciences Turkiye, Tepecik Training and Research Hospital, Izmir, Turkiye
6Intensive Care Unit, University of Health Sciences, Dr. Suat Seren Chest Diseases and Surgery Training and Research Hospital, Intensive Care Unit, Izmir, Turkiye
J Crit Intensive Care 2024; 15(1): 16-22 DOI: 10.14744/dcybd.2023.3638
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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 ventila-tion 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.