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MINERVA ANESTESIOLOGICA

A Journal on Anesthesiology, Resuscitation, Analgesia and Intensive Care


Official Journal of the Italian Society of Anesthesiology, Analgesia, Resuscitation and Intensive Care
Indexed/Abstracted in: Current Contents/Clinical Medicine, EMBASE, PubMed/MEDLINE, Science Citation Index Expanded (SciSearch), Scopus
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Minerva Anestesiologica 2017 Jul 05

DOI: 10.23736/S0375-9393.17.11963-2

Copyright © 2017 EDIZIONI MINERVA MEDICA

language: English

Closed loop ventilation mode in intensive care unit: a randomized controlled clinical trial comparing the numbers of manual ventilator setting changes

Jean-Michel ARNAL 1, 2 , Aude GARNERO 1, Dominik NOVOTNI 2, Gaëlle CORNO 1, Stéphane Y. DONATI 1, Didier DEMORY 1, Gabrielle QUINTANA 1, Laurent DUCROS 1, Thomas LAUBSCHER 2, Jacques DURAND-GASSELIN 1

1 Service de Réanimation Polyvalente, Hôpital Sainte Musse, Deville, Toulon, France; 2 Research and Development Department, Hamilton Medical AG, Bonaduz, Switzerland


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BACKGROUND: There is an equipoise regarding closed-loop ventilation modes and the ability to reduce workload for providers. On one hand some settings are managed by the ventilator but on another hand the automatic mode introduces new settings for the user.
METHODS: This randomized controlled trial compared the number of manual ventilator setting changes between a full closed loop ventilation and oxygenation mode (INTELLiVENT-ASV®) and conventional ventilation modes (volume assist control and pressure support) in intensive care unit (ICU) patients. The secondary endpoints were to compare the number of arterial blood gas analysis, the sedation dose and the user acceptance. Sixty subjects with an expected duration of mechanical ventilation of at least 48 hours were randomized to be ventilated using INTELLiVENT-ASV® or conventional modes with a protocolized weaning. All manual ventilator setting changes were recorded continuously from inclusion to successful extubation or death. Arterial blood gases were performed upon decision of the clinician in charge. User acceptance score was assessed for nurses and physicians once daily using a Likert scale.
RESULTS: The number of manual ventilator setting changes per 24 h-period per subject was lower in INTELLiVENT-ASV® as compared to conventional ventilation group (5 (4-7) versus 10 (7-17) manuals settings per subject per day (p<.001)). The number of arterial blood gas analysis and the sedation doses were not significantly different between the groups. Nurses and physicians reported that INTELLiVENT-ASV® was significantly easier to use as compared to conventional ventilation (p<0.001 for nurses and p<0.01 for physicians).
CONCLUSIONS: For mechanically ventilated ICU patients, INTELLiVENT-ASV® significantly reduces the number of manual ventilator setting changes with the same number of arterial blood gas analysis and sedation dose, and is easier to use for the caregivers as compared to conventional ventilation modes.


KEY WORDS: Critical care - Respiratory insufficiency - Respiratory distress syndrome - Mechanical ventilation - Ventilators - Automation

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Publication History

Manuscript first published online: July 05, 2017
Manuscript accepted: June 24, 2017
Manuscript revised: June 7, 2017
Manuscript received: January 24, 2017

Cite this article as

Arnal JM, Garnero A, Novotni D, Corno G, Donati SY, Demory D, et al. Closed loop ventilation mode in intensive care unit: a randomized controlled clinical trial comparing the numbers of manual ventilator setting changes. Minerva Anestesiol 2017 Jul 05. DOI: 10.23736/S0375-9393.17.11963-2

Corresponding author e-mail

jean-michel@arnal.org