Automated vs. conventional ventilation in the ICU: a randomized controlled crossover trial comparing blood oxygen saturation during daily nursing procedures (I-NURSING)

Autor: Jonathan Chelly, Sandie Mazerand, Sebastien Jochmans, Claire-Marie Weyer, Franck Pourcine, Olivier Ellrodt, Nathalie Thieulot-Rolin, Jean Serbource-Goguel, Oumar Sy, Ly Van Phach Vong, Mehran Monchi
Jazyk: angličtina
Rok vydání: 2020
Předmět:
Zdroj: Critical Care, Vol 24, Iss 1, Pp 1-9 (2020)
Druh dokumentu: article
ISSN: 1364-8535
DOI: 10.1186/s13054-020-03155-3
Popis: Abstract Background Hypoxia is common during daily nursing procedures (DNPs) routinely performed on mechanically ventilated patients. The impact of automated ventilation on the incidence and severity of blood oxygen desaturation during DNPs remains unknown. Methods A prospective randomized controlled crossover trial was carried out in a French intensive care unit to compare blood oxygen pulse saturation (SpO2) during DNPs performed on patients mechanically ventilated in automated and conventional ventilation modes (AV and CV, respectively). All patients with FiO2 ≤ 60% and without prone positioning or neuromuscular blocking agents were included. Patients underwent two DNPs on the same day using AV (INTELLiVENT-ASV®) and CV (volume control, biphasic positive airway pressure, or pressure support ventilation) in a randomized order. The primary outcome was the percentage of time spent with SpO2 in the acceptable range of 90–95% during the DNP. Results Of the 265 included patients, 93% had been admitted for a medical pathology, the majority for acute respiratory failure (52%). There was no difference between the two periods in terms of DNP duration, sedation requirements, or ventilation parameters, but patients had more spontaneous breaths and lower peak airway pressures during the AV period (p
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