Evaluation of Respiratory Parameters in Patients with Acute Lung Injury Receiving Adaptive Support Ventilation

Adaptive support ventilation (ASV) is a closed-loop ventilation, which can make automatic adjustments in tidal volume (VT) and respiratory rate based on the minimal work of breathing. The purpose of this research was to study whether ASV can provide a protective ventilation pattern to decrease the risk of ventilator-induced lung injury in patients of acute respiratory distress syndrome (ARDS). In the clinical study, 15 ARDS patients were randomly allocated to an ASV group or a pressure-control ventilation (PCV) group. There was no significant difference in the mortality rate and respiratory parameters between these two groups, suggesting the feasible use of ASV in ARDS. In animal experiments of 18 piglets, the ASV group had a lower alveolar strain compared with the volume-control ventilation (VCV) group. The ASV group exhibited less lung injury and greater alveolar fluid clearance compared with the VCV group. Tissue analysis showed lower expression of matrix metalloproteinase 9 and higher expression of claudin-4 and occludin in the ASV group than in the VCV group. In conclusion, the ASV mode is capable of providing ventilation pattern fitting into the lung-protecting strategy; this study suggests that ASV mode may effectively reduce the risk or severity of ventilator-associated lung injury in animal models.

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Comparing the Effect of Adaptive Support Ventilation (ASV) and Synchronized Intermittent Mandatory Ventilation (SIMV) on Respiratory Parameters in Neurosurgical ICU Patients

Anesthesiology and Pain Medicine ◽

10.5812/aapm.40368 ◽

2016 ◽

Vol 6 (6) ◽

Cited By ~ 2

Author(s):

Mohammadreza Ghodrati ◽

Alireza Pournajafian ◽

Ali Khatibi ◽

Mohammad Niakan ◽

Mohammad Hosein Hemadi ◽

...

Keyword(s):

Intermittent Mandatory Ventilation ◽

Icu Patients ◽

Adaptive Support Ventilation ◽

Support Ventilation ◽

Respiratory Parameters ◽

Adaptive Support

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Adaptive support ventilation attenuates postpneumonectomy acute lung injury in a porcine model

Interactive CardioVascular and Thoracic Surgery ◽

10.1093/icvts/ivaa157 ◽

2020 ◽

Vol 31 (5) ◽

pp. 718-726

Author(s):

Yu-Ling Dai ◽

Ren-Jun Hsu ◽

Hsu-Kai Huang ◽

Tsai-Wang Huang ◽

Wen-Chiuan Tsai ◽

...

Keyword(s):

Lung Injury ◽

Mechanical Stress ◽

Minute Ventilation ◽

Volume Control ◽

Control Group ◽

Breathing Patterns ◽

Adaptive Support Ventilation ◽

Support Ventilation ◽

Ventilator Induced Lung Injury ◽

Adaptive Support

Abstract OBJECTIVES An optimal ventilation strategy that causes as little mechanical stress and inflammation as possible is critical for patients undergoing pneumonectomy. The aim of this study was to determine whether adaptive support ventilation (ASV) can provide protective ventilation to the remaining lung after pneumonectomy with minimal mechanical stress and less inflammation than volume-control ventilation (VCV). METHODS In this study, 15 pigs were randomly allocated to 3 groups (n = 5 for each group): the control group, the VCV group and the ASV group. After left pneumonectomy, the VCV group was treated with the volume-control set to 20 ml/kg, and the ASV group with the mode set to achieve 60% of the minute ventilation of 2 lungs. RESULTS The ASV group had lower alveolar strain than the VCV group. The ASV group exhibited less lung injury and greater alveolar fluid clearance than the VCV group (13.3% vs −17.8%; P ≤ 0.018). Ventilator-induced lung injury was associated with changes in the cytokine levels in the exhaled breath condensate, differential changes in plasma and changes in the cytokines in the bronchoalveolar lavage fluid. Expression of 3 microRNAs (miR449b-3p, P ≤ 0.001; miR451-5p, P = 0.027; and miR144-5p, P = 0.008) was increased in the VCV group compared with the ASV group. CONCLUSIONS The ASV mode was capable of supporting rapid, shallow breathing patterns to exert lung-protective effects in a porcine postpneumonectomy model. Further investigation of microRNAs as biomarkers of ventilator-induced lung injury is warranted.

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

Birat Journal of Health Sciences ◽

10.3126/bjhs.v1i1.17090 ◽

2017 ◽

Vol 1 (1) ◽

pp. 8-12

Author(s):

L.K. Rajbanshi ◽

M. Dali ◽

S.B. Karki ◽

K. Khanal ◽

B. Aryal ◽

...

Keyword(s):

Intensive Care Unit ◽

Mechanical Ventilation ◽

Intensive Care ◽

Observational Study ◽

Ventilatory Support ◽

Control Mode ◽

Adaptive Support Ventilation ◽

Support Ventilation ◽

Adaptive Support ◽

The Mean

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

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