Effect of INTELLiVENT-ASV versus Conventional Ventilation on Ventilation Intensity in Patients with COVID-19 ARDS—An Observational Study

Autor:	Pim L.J. van der Heiden, Laura A. Buiteman-Kruizinga, Marcus J. Schultz, Ary Serpa Neto, Frederique Paulus, Matthijs D. Kruizinga, Hassan E. Mkadmi, Michela Botta
Přispěvatelé:	Intensive Care Medicine, Graduate School, ACS - Pulmonary hypertension & thrombosis, AII - Inflammatory diseases, Nursing, ACS - Diabetes & metabolism, ACS - Microcirculation
Jazyk:	angličtina
Rok vydání:	2021
Předmět:	medicine.medical_specialty ARDS animal structures Coronavirus disease 2019 (COVID-19) mechanical power INTELLiVENT‐ASV driving pressure INTELLiVENT-ASV Article Mean difference automated ventilation COVID‐19 Intensive care Internal medicine medicine In patient Closed‐loop ventilation business.industry COVID-19 General Medicine medicine.disease Intensity (physics) intensity of ventilation Cardiology Breathing closed-loop ventilation Medicine business Conventional ventilation
Zdroj:	Journal of Clinical Medicine Volume 10 Issue 22 Journal of Clinical Medicine, Vol 10, Iss 5409, p 5409 (2021) Journal of clinical medicine, 10(22):5409. Multidisciplinary Digital Publishing Institute (MDPI)
ISSN:	2077-0383
DOI:	10.3390/jcm10225409
Popis:	Driving pressure (ΔP) and mechanical power (MP) are associated with outcomes in critically ill patients, irrespective of the presence of Acute Respiratory Distress Syndrome (ARDS). INTELLiVENT-ASV, a fully automated ventilatory mode, controls the settings that affect ΔP and MP. This study compared the intensity of ventilation (ΔP and MP) with INTELLiVENT-ASV versus conventional ventilation in a cohort of COVID-19 ARDS patients in two intensive care units in the Netherlands. The coprimary endpoints were ΔP and MP before and after converting from conventional ventilation to INTELLiVENT-ASV. Compared to conventional ventilation, INTELLiVENT-ASV delivered ventilation with a lower ΔP and less MP. With conventional ventilation, ΔP was 13 cmH2O, and MP was 21.5 and 24.8 J/min, whereas with INTELLiVENT-ASV, ΔP was 11 and 10 cmH2O (mean difference –2 cm H2O (95 %CI –2.5 to –1.2 cm H2O), p < 0.001) and MP was 18.8 and 17.5 J/min (mean difference –7.3 J/Min (95% CI –8.8 to –5.8 J/min), p < 0.001). Conversion from conventional ventilation to INTELLiVENT-ASV resulted in a lower intensity of ventilation. These findings may favor the use of INTELLiVENT-ASV in COVID-19 ARDS patients, but future studies remain needed to see if the reduction in the intensity of ventilation translates into clinical benefits.
Databáze:	OpenAIRE
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