Comparisons of Metabolic Load between Adaptive Support Ventilation and Pressure Support Ventilation in Mechanically Ventilated ICU Patients

Chen, Yen-Huey; Hsiao, Hsiu-Feng; Hsu, Hui-Wen; Cho, Hsiu-Ying; Huang, Chung-Chi

doi:10.1155/2020/2092879

Cited by 4 publications

(2 citation statements)

References 17 publications

(22 reference statements)

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“…6], nor can we predict which patients will fail at weaning [7,8]. the use of aSV for weaning and safe ventilation of patients has been proven in several trials, and our experience highlights the ease and safety of the use of this mode of ventilation [9][10][11].…”

Section: Resultsmentioning

confidence: 93%

Weaning patients off mechanical ventilation in a chronic ventilation facility – using a standardized approach

Heerden¹,

Krugman²,

Bouhnish³

2022

ait

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Background:We describe the standardised management of patients in a chronic ventilation facility (CVF) and the rate of weaning of chronically ventilated patients off mechanical ventilation. This population of patients is transferred from acute care facilities where they have been deemed "non-weanable" and require prolonged ventilation.Methods: Admissions to our CVF were audited over a period of 3 years. We collected demographic and outcome data as well as the patients' length of stay and disposition. Weaning in our centre proceeds step-wise with a reduction in the adaptive support ventilation (ASV) minute ventilation target. Once the target reaches 50% of minute ventilation, spontaneous breathing trials are introduced and progressively lengthened until the patient is weaned.Results: In total, 125 patients were admitted during the 3 years. 109 were not weaned, and 16 were weaned, i.e. 12.8% of patients were safely weaned off mechanical ventilation. Of the patients not weaned, the mortality rate was 34.8%, and 38.5% were discharged alive to either home or another facility. Conclusions:Weaning chronically ventilated patients is possible without intensivists or respiratory therapists on staff when a standardised approach/manner is implemented. However, weaning success appears to be mainly related to patients' co-morbidities.

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Section: Resultsmentioning

confidence: 93%

Weaning patients off mechanical ventilation in a chronic ventilation facility – using a standardized approach

Heerden¹,

Krugman²,

Bouhnish³

2022

ait

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“…The ventilation mode may unjustly influence measured EE by directly affecting the measured gas flow used for calculation [ 15 , 82 , 83 ]. As the device uses the amount of inspired and expired N 2 as a control to define the amount of inspired and expired oxygen and carbon dioxide, the amount of N 2 will be too low to get a reliable result, when the fraction of inspired oxygen is too high.…”

Section: Indirect Calorimetrymentioning

confidence: 99%

Energy expenditure and indirect calorimetry in critical illness and convalescence: current evidence and practical considerations

2021

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The use of indirect calorimetry is strongly recommended to guide nutrition therapy in critically ill patients, preventing the detrimental effects of under- and overfeeding. However, the course of energy expenditure is complex, and clinical studies on indirect calorimetry during critical illness and convalescence are scarce. Energy expenditure is influenced by many individual and iatrogenic factors and different metabolic phases of critical illness and convalescence. In the first days, energy production from endogenous sources appears to be increased due to a catabolic state and is likely near-sufficient to meet energy requirements. Full nutrition support in this phase may lead to overfeeding as exogenous nutrition cannot abolish this endogenous energy production, and mitochondria are unable to process the excess substrate. However, energy expenditure is reported to increase hereafter and is still shown to be elevated 3 weeks after ICU admission, when endogenous energy production is reduced, and exogenous nutrition support is indispensable. Indirect calorimetry is the gold standard for bedside calculation of energy expenditure. However, the superiority of IC-guided nutritional therapy has not yet been unequivocally proven in clinical trials and many practical aspects and pitfalls should be taken into account when measuring energy expenditure in critically ill patients. Furthermore, the contribution of endogenously produced energy cannot be measured. Nevertheless, routine use of indirect calorimetry to aid personalized nutrition has strong potential to improve nutritional status and consequently, the long-term outcome of critically ill patients.

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Closed-Loop Ventilation Modes

Arnal

Schaedler

Kıraklı

2022

Mechanical Ventilation From Pathophysiology to Clinical Evidence

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Comparisons of Metabolic Load between Adaptive Support Ventilation and Pressure Support Ventilation in Mechanically Ventilated ICU Patients

Cited by 4 publications

References 17 publications

Weaning patients off mechanical ventilation in a chronic ventilation facility – using a standardized approach

Weaning patients off mechanical ventilation in a chronic ventilation facility – using a standardized approach

Energy expenditure and indirect calorimetry in critical illness and convalescence: current evidence and practical considerations

Closed-Loop Ventilation Modes

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