Home > Riviste > Minerva Anestesiologica > Fascicoli precedenti > Minerva Anestesiologica 2019 August;85(8) > Minerva Anestesiologica 2019 August;85(8):862-70

ULTIMO FASCICOLO
 

JOURNAL TOOLS

eTOC
Per abbonarsi
Sottometti un articolo
Segnala alla tua biblioteca
 

ARTICLE TOOLS

Publication history
Estratti
Permessi
Per citare questo articolo

 

ORIGINAL ARTICLE   Freefree

Minerva Anestesiologica 2019 August;85(8):862-70

DOI: 10.23736/S0375-9393.19.12618-1

Copyright © 2019 EDIZIONI MINERVA MEDICA

lingua: Inglese

Proportional assist ventilation feasibility in the early stage of respiratory failure: a prospective randomized multicenter trial

Marcos DELGADO 1 , Carles SUBIRÁ 2, 3, Cecilia HERMOSA 4, Federico GORDO 4, Jordi RIERA 5, Rafael FERNÁNDEZ 2, 3

1 Department of Anesthesiology, Intensive Care Unit, Bürgerspital Solothurn, Solothurn, Switzerland; 2 Intensive Care Unit, Hospital Sant Joan de Deu, Althaia Xarxa Assistencial, Manresa, Spain; 3 CIBERES, International University of Catalunya, Barcelona, Spain; 4 Intensive Care Unit, University Hospital of Henares, Coslada, Spain; 5 Intensive Care Unit, Hospital of Vall d’Hebron, Barcelona, Spain



BACKGROUND: Proportional assist ventilation (PAV+) is an assisted ventilator mode usually applied during weaning. We aimed to determine the feasibility of using PAV+ in the early phase of acute respiratory failure compared to volume-assist control ventilation (V-ACV) in order to shorten the length of mechanical ventilation (MV).
METHODS: We conducted a prospective randomized trial comparing high-assistance PAV+ (gain 80%) vs. V-ACV in four university hospital Intensive Care Units. Patients were included based on a previous pilot trial. Length of MV was the main objective. Secondary objectives were length of stay (LOS) in ICU/hospital, and ICU/hospital/60-day mortality. Statistics: Mann-Whitney U Test and Fisher’s Exact Test.
RESULTS: We could not find differences in length of MV or any of the analyzed variables between the 52 patients with PAV+ and 50 patients with V-ACV. The high PAV+ failure rate (42%) was attributed to excessive sedation, high respiratory rate, and high respiratory effort.
CONCLUSIONS: The use of high-assistance PAV+ in the early phase of MV does not present benefits compared to V-ACV. The high rate of PAV+ failure reinforces the need for sedative optimization, learning curve, and better patient selection.


KEY WORDS: Respiration, artificial; Interactive ventilatory support; Respiratory distress syndrome, adult

inizio pagina