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Adaptive support ventilation as an acceptable mode to prevent airflow limitation, air entrapment, dynamic hyperinflation and patient-ventilator dyssynchrony

  • A Taha
  • A Shafie
  • Y Lavoie
  • H Hubert
  • R Marktanner
Open Access
Poster presentation
  • 265 Downloads

Keywords

Neuromuscular Blockage Airflow Limitation Ventilation Modality Peak Airway Pressure Automate Adjustment 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

Introduction

Adaptive support ventilation (ASV) is a dual control mode, using measured dynamic compliance and time constant, with an automated adjustment of tidal volume and respiratory rate combined to meet the preset minute ventilation. The purpose of this study was to evaluate the effectiveness of (ASV) in restoring air flow stability, decrease work of breathing and improving dys-synchrony in ventilated patients with variable airway resistance.

Methods

20 ICU patients showing air entrapment, Dynamic Hyperinflation and patient-ventilator dyssynchrony were enrolled between january 2014 and March 2015. Data was collected 48 hours after switching to ASV, which was applied with the same protocol. All enrolled patients were hemodynamically monitored. A retrospective analysis of this data was performed.

Results

Completed data sets were obtained from 20 patients. the average peak airway pressure was 28 cm H2O. Peak airway pressure decreased 19% (p < 0.01), flow time curves improved by 80% (p < 0.001), with decrease work of breathing (p < 0.015) over short time from starting the patient on ASV mode.

Conclusions

In our patient series, ASV significantly improved dys-synchrony by using measured dynamic compliance and time constant cycle by cycle with subsequent optimization of flow time curves with less use of sedation and neuromuscular blockage. Furthermore, this strategy improved hemodynamics and facilitated weaning from MV. Therefore, our data suggests, that this ventilation modality has favorable results and appears to be an effective tool in patients with air flow resistance, who develop air entrapment, Dynamic Hyperinflation and patient-ventilator dyssynchrony during their ICU stay.

References

  1. 1.
    Branson RD, Chatburn RL: Controversies in the critical care setting. Should adaptive pressure control modes be utilized for virtually all patients receiving mechanical ventilation?. Respir Care. 2007, 52: 478-485. discussion 485-78PubMedGoogle Scholar
  2. 2.
    Jaber S, Delay JM, Matecki S, et al: Volume-guaranteed pressure-support ventilation facing acute changes in ventilatory demand. Intens Care Med. 2005, 31: 1181-8. 10.1007/s00134-005-2726-x.CrossRefGoogle Scholar

Copyright information

© Taha et al.; 2015

This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Authors and Affiliations

  • A Taha
    • 1
  • A Shafie
    • 1
    • 2
  • Y Lavoie
    • 3
  • H Hubert
    • 1
  • R Marktanner
    • 1
  1. 1.Division of Adult Cardiac and Transplant Critical Care, Critical Care DepartmentSheikh Khalifa Medical City Managed by Cleveland ClinicAbu DhabiUnited Arab Emirates
  2. 2.Division of Respiratory Therapy, Respiratory Therapy DepartmentSheikh Khalifa Medical City Managed by Cleveland ClinicAbu DhabiUnited Arab Emirates
  3. 3.Division of Respiratory TherapyRespiratory Therapy DepartmentAbu DhabiUnited Arab Emirates

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