Adaptive Support Ventilation as a Sole Mode of Mechanical Ventilation-An Observational Study

Introduction Adaptive support ventilation (ASV) is a close loop dual control mechanical ventilation mode. This mode can automatically change its parameters to weaning mode once the patient is actively breathing converting volume targeted pressure control mode to volume targeted pressure support mode. We aimed to observe the outcome of the patients ventilated with ASV as a sole mode in terms of duration of mechanical ventilation, duration of weaning from the ventilatory support and length of Intensive care unit (ICU) stay.Methodology We conducted a prospective observational study for the duration of six months (Sept 2015 to Feb 2016) to assess the clinical outcome of the patients ventilated by ASV as a sole mode of ventilation. The study conducted observation of 78 patients without chronic respiratory, renal, hepatic and neurological disease who were admitted in our intensive care unit for invasive ventilatory support.Results Out of the 187 patients who required invasive and noninvasive ventilation, only 78 patients fulfilled the criteria to be included in the study. It was observed that the mean duration of mechanical ventilation was 5.4 days while weaning as well as tracheal extubation was successful within 13 hours of initiation of weaning. The mean duration of ICU stay was found to be 6.3 days.Conclusion We concluded that the patient ventilated by ASV mode were effectively weaned without the need of changing the ventilator mode. However, the safety of ASV mode needs to be established by large randomized control trail in a wide spectrum of patients.Birat Journal of Health Sciences 2016 1(1): 8-12

Download Full-text

Effects of Implementing Adaptive Support Ventilation in a Medical Intensive Care Unit

Respiratory Care ◽

10.4187/respcare.00966 ◽

2011 ◽

Vol 56 (7) ◽

pp. 976-983 ◽

Cited By ~ 12

Author(s):

C.-W. Chen ◽

C.-P. Wu ◽

Y.-L. Dai ◽

W.-C. Perng ◽

C.-F. Chian ◽

...

Keyword(s):

Intensive Care Unit ◽

Intensive Care ◽

Medical Intensive Care Unit ◽

Adaptive Support Ventilation ◽

Support Ventilation ◽

Adaptive Support ◽

Medical Intensive Care

Download Full-text

Weaning From Noninvasive Ventilatory Support in Infants With Severe Bronchiolitis: An Observational Study

10.21203/rs.3.rs-622817/v1 ◽

2021 ◽

Author(s):

Julie Cassibba ◽

Claire Freycon ◽

Julia Doutau ◽

Isabelle Pin ◽

Alexandre Bellier ◽

...

Keyword(s):

Intensive Care Unit ◽

Intensive Care ◽

Observational Study ◽

Pediatric Intensive Care Unit ◽

Positive Airway Pressure ◽

Ventilatory Support ◽

Winter Season ◽

Pediatric Intensive Care ◽

High Flow Nasal Cannula ◽

Tertiary Center

Abstract Background: The aim of the study was to analyze the weaning success, the type of weaning procedures, and weaning duration in consecutive infants hospitalized over a winter season in a Pediatric Intensive Care Unit.Methods: A retrospective observational study in a pediatric intensive care unit in a tertiary center. Infants hospitalized for a severe bronchiolitis were included and the weaning procedure from continuous positive airway pressure (CPAP), noninvasive ventilation (NIV) or high flow nasal cannula (HFNC) was analyzed.Results: Data from 95 infants (median age 47 days) were analyzed. On admission, 26 (27%), 46 (49%) and 23 (24%) infants were supported by CPAP, NIV and HFNC, respectively. One (4%), nine (20%) and one (4%) infants failed weaning while supported by CPAP, NIV or HFNC, respectively (p=0.1). In infants supported by CPAP, CPAP was stopped directly in 5 patients (19%) while HFNC was used as an intermediate ventilatory support in 21 (81%). The duration of weaning was shorter for HFNC (17 hours, [IQR 0-26]) than for CPAP (24 hours, [14-40]) and NIV (28 hours, [19-49]) (p<0.01).Conclusions: The weaning phase represent a large proportion of noninvasive ventilatory support duration in infants with bronchiolitis. The weaning procedure following a “step down” strategy may lead to an increase in duration of weaning.

Download Full-text

Ventilator-Associated Pneumonia in a Pediatric Intensive Care Unit in Saudi Arabia: A 30-Month Prospective Surveillance

Infection Control and Hospital Epidemiology ◽

10.1086/502472 ◽

2004 ◽

Vol 25 (9) ◽

pp. 753-758 ◽

Cited By ~ 67

Author(s):

Maha Almuneef ◽

Ziad A. Memish ◽

Hanan H. Balkhy ◽

Hala Alalem ◽

Abdulrahman Abutaleb

Keyword(s):

Intensive Care Unit ◽

Mechanical Ventilation ◽

Saudi Arabia ◽

Intensive Care ◽

Antibiotic Therapy ◽

Pediatric Intensive Care ◽

Ventilator Associated Pneumonia ◽

Prospective Surveillance ◽

The Mean ◽

Prior Antibiotic Therapy

AbstractObjective:To describe the rate, risk factors, and outcome of ventilator-associated pneumonia (VAP) in pediatric patients.Methods:This prospective surveillance study of VAP among all patients receiving mechanical ventilation for 48 hours or more admitted to a pediatric intensive care unit (PICU) in Saudi Arabia from May 2000 to November 2002 used National Nosocomial Infections Surveillance (NNIS) System definitions.Results:Three hundred sixty-one eligible patients were enrolled. Most were Saudi with a mean age of 28.6 months. Thirty-seven developed VAP. The mean VAP rate was 8.87 per 1,000 ventilation-days with a ventilation utilization rate of 47%. The mean duration of mechanical ventilation was 21 days for VAP patients and 10 days for non-VAP patients. The mean PICU stay was 34 days for VAP patients and 15 days for non-VAP patients. Among VAP patients, Pseudomonas aeruginosa was the most common organism, followed by Staphylococcus aureus. Other gram-negative organisms were also encountered. There was no significant difference between VAP and non-VAP patients regarding mortality rate. Witnessed aspiration, reintubation, prior antibiotic therapy, continuous enteral feeding, and bronchoscopy were associated with VAP. On multiple logistic regression analysis, only prior antibiotic therapy, continuous enteral feeding, and bronchoscopy were independent predictors of VAP.Conclusions:The mean VAP rate in this hospital was higher than that reported by NNIS System surveillance of PICUs. This study has established a benchmark for future studies of VAP in the pediatric intensive care population in Saudi Arabia. Additional studies from the region are necessary for comparison and development of preventive measures.

Download Full-text

Machine learning for the prediction of successful extubation among patients with mechanical ventilation in the intensive care unit: A retrospective observational study

Journal of Nippon Medical School ◽

10.1272/jnms.jnms.2021_88-508 ◽

2021 ◽

Author(s):

Takanobu Otaguro ◽

Hidenori Tanaka ◽

Yutaka Igarashi ◽

Takashi Tagami ◽

Tomohiko Masuno ◽

...

Keyword(s):

Machine Learning ◽

Intensive Care Unit ◽

Mechanical Ventilation ◽

Intensive Care ◽

Observational Study ◽

Retrospective Observational Study ◽

Successful Extubation

Download Full-text

Síndrome de Dificuldade Respiratória Aguda: Casuística de Dois Anos numa Unidade de Cuidados Intensivos

Acta Médica Portuguesa ◽

10.20344/amp.4266 ◽

2014 ◽

Vol 27 (2) ◽

pp. 211 ◽

Cited By ~ 1

Author(s):

Lúcia Taborda ◽

Filipa Barros ◽

Vitor Fonseca ◽

Manuel Irimia ◽

Ramiro Carvalho ◽

...

Keyword(s):

Intensive Care Unit ◽

Mechanical Ventilation ◽

Acute Respiratory Distress Syndrome ◽

Intensive Care ◽

Respiratory Distress Syndrome ◽

Respiratory Distress ◽

Distress Syndrome ◽

Invasive Mechanical Ventilation ◽

Interquartile Range ◽

The Mean

Introduction: Acute Respiratory Distress Syndrome has a significant incidence and mortality at Intensive Care Units. Therefore, more studies are necessary in order to develop new effective therapeutic strategies. The authors have proposed themselves to characterize Acute Respiratory Distress Syndrome patients admitted to an Intensive Care Unit for 2 years. Material and Methods: This was an observational retrospective study of the patients filling the Acute Respiratory Distress Syndrome criteria from the American-European Consensus Conference on ARDS, being excluded those non invasively ventilated. Demographic data, Acute Respiratory Distress Syndrome etiology, comorbidities, Gravity Indices, PaO2/FiO2, ventilator modalities and programmation, pulmonary compliance, days of invasive mechanical ventilation, corticosteroids use, rescue therapies, complications, days at Intensive Care Unit and obits were searched for and were submitted to statistic description and analysis. Results: A 40 patients sample was obtained, with a median age of 72.5 years (interquartile range = 22) and a female:male ratio of ≈1:1.86. Fifty five percent of the Acute Respiratory Distress Syndrome cases had pulmonary etiology. The mean minimal PaO2/FiO2 was 88mmHg (CI 95%: 78.5–97.6). The mean maximal applied PEEP was 12.4 cmH2O (Standard Deviation 4.12) and the mean maximal used tidal volume was 8.2 mL/ Kg ideal body weight (CI 95%: 7.7–8.6). The median invasive mechanical ventilation days was 10. Forty seven and one half percent of the patients had been administered corticosteroids and 52.5% had been submitted to recruitment maneuvers. The most frequent complication was Ventilator Associated Pneumonia (20%). The median Intensive Care Unit stay was 10.7 days (interquartile range 10.85). The fatality rate was 60%. The probability of the favorable outcome ‘non-death in Intensive Care Unit’ was 4.4x superior for patients who were administered corticosteroids and 11x superior for patients < 65 years old. Discussion and Conclusions: Acute Respiratory Distress Syndrome is associated with long hospitalization and significant mortality. New prospective studies will be necessary to endorse the potential benefit of steroid therapy and to identify the subgroups of patients that warrant its use.

Download Full-text

An easy way to estimate energy expenditure from hemodynamic data in septic patients

Acta Cirurgica Brasileira ◽

10.1590/s0102-86502008000700019 ◽

2008 ◽

Vol 23 (suppl 1) ◽

pp. 112-117 ◽

Cited By ~ 2

Author(s):

Anibal Basile-Filho ◽

Maria Auxiliadora Martins ◽

Flavio Marson ◽

Paulo Roberto Barbosa Evora

Keyword(s):

Intensive Care Unit ◽

Mechanical Ventilation ◽

Intensive Care ◽

Oxygen Consumption ◽

Energy Expenditure ◽

Resting Energy Expenditure ◽

University Hospital ◽

Predictive Equations ◽

Metabolic Cart ◽

The Mean

PURPOSE: The purpose of this study is to compare the resting energy expenditure (REE) obtained by indirect calorimetry (IC) to the REE calculated by predictive equations (Brandi and Liggett) using the oxygen consumption (VO2) obtained by Fick's method in septic patients. METHODS: Prospective study in septic patients admitted in an intensive care unit of a university hospital. Fifteen adult patients (11 men and four women) were studied. VO2 measurements were made using a portable metabolic cart connected to a respirator and a pulmonary artery catheter. RESULTS: The APACHE II at admission was 22.6±7.2 with a mortality risk of 46.1±27.7%. The mean REE obtained by IC and by the Brandi and Liggett equations were 1699±271, 1815±355 and 1361±277 kcal.day-1 respectively. There were no statistically significant differences between the two methods, with the two means showing a difference of 8.7%. REE values were close for IC x BRANDI (r=0.80), but the IC x LIGGETT correlation was only 0.58. CONCLUSIONS: The results suggest that REE can be easily calculated by obtaining VO2 with the Swan-Ganz catheter and using the Brandi equation even for septic patients under mechanical ventilation.

Download Full-text