Safety and efficacy of a fully closed-loop control ventilation (IntelliVent-ASV®) in sedated ICU patients with acute respiratory failure: a prospective randomized crossover study

Arnal, Jean-Michel; Wysocki, Marc; Novotni, Dominik; Demory, Didier; Lopez, Rigoberto; Donati, Stéphane Y.; Granier, I.; Corno, Gaëlle; Durand-Gasselin, Jacques

doi:10.1007/s00134-012-2548-6

Cited by 78 publications

(91 citation statements)

References 26 publications

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“…12 Intellivent is a ventilator mode that incorporates the ARDS Network tables into the ventilator software. [60][61][62] PEEP/F IO 2 tables were also used in the Lung Open Ventilation study, 51 very similar to those used by the ARDS Network. In 51 subjects, Chiumello et al 17 compared the use of this table against 3 other approaches for setting PEEP: compliance, 63 stress index, 64 and esophageal manometry.…”

Section: Gas Exchangementioning

confidence: 99%

Recruitment Maneuvers and PEEP Titration

2015

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The injurious effects of alveolar overdistention are well accepted, and there is little debate regarding the importance of pressure and volume limitation during mechanical ventilation. The role of recruitment maneuvers is more controversial. Alveolar recruitment is desirable if it can be achieved, but the potential for recruitment is variable among patients with ARDS. A stepwise recruitment maneuver, similar to an incremental PEEP titration, is favored over sustained inflation recruitment maneuvers. Many approaches to PEEP titration have been proposed, and the best method to choose the most appropriate level for an individual patient is unclear. A PEEP level should be selected that balances alveolar recruitment against overdistention. The easiest approach to select PEEP might be according to the severity of the disease: 5-10 cm H 2 O PEEP in mild ARDS, 10 -15 cm H 2 O PEEP in moderate ARDS, and 15-20 cm H 2 O PEEP in severe ARDS. Recruitment maneuvers and PEEP should be used within the context of lung protection and not just as a means of improving oxygenation.

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Section: Gas Exchangementioning

confidence: 99%

Recruitment Maneuvers and PEEP Titration

2015

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“…New systems that combine automatic adjustments of ventilator parameters, such as minute ventilation and peak inspiratory pressure, in parallel to automatic adjustment of F IO 2 and PEEP, have recently become available. 40,41 Reports on the use of these systems in adult ventilated patients with acute lung injury and post-cardiac surgery indicate better maintenance of the target ranges of oxygenation and other physiologic targets, less hyperoxemia, and reductions in F IO 2 . These more sophisticated systems also resulted in fewer manual interventions from the clinical team to adjust the ventilator settings.…”

Section: In the Adultmentioning

confidence: 99%

Automated Closed Loop Control of Inspired Oxygen Concentration

Claure

Bancalari

2012

Respir Care

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Oxygen therapy is extensively used in premature infants and adults with respiratory insufficiency. In the premature infant the goal during manual control of the F IO 2 is to maintain adequate oxygenation and to minimize the exposure to hypoxemia, hyperoxemia, and oxygen. However, this is frequently not achieved during routine care, which increases the risks of associated side effects affecting the eye, lungs, and central nervous system. In the adult the primary goal is to avoid hypoxemia, but conventional methods of oxygen supplementation may fall short during periods of increased demand. On the other hand, there are growing concerns related to unnecessarily high F IO 2 levels that increase the exposure to hyperoxemia and excessive oxygen use in settings where resources are limited. Systems for automated closed loop control of F IO 2 have been developed for use in neonates and adults. This paper will give an overview of the rationale for the development of these systems, present the evidence, and discuss important advantages and limitations.

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“…This mode adds a control of minute volume according to the end-tidal carbon dioxide monitoring and adjusts PEEP and FiO 2 according to the peripheral oxygen saturation. Arnal et al 42 performed a short-term randomized study in 50 sedated patients and compared two hours of MV under conventional ASV modality versus two hours under IntelliVent-ASV ® modality. They found that IntelliVent-ASV ® as compared to ASV was safe and permitted to ventilate patients with less plateau pressure (24 versus 20 cm H 2 O; p = 0.005) and less F i O 2 (40 versus 30%; p = 0.001), while maintaining similar oxygenation.…”

Section: Barcelona Respiratory Networkmentioning

confidence: 99%

The Process of Weaning from Mechanical Ventilation

Aguirre-Bermeo¹,

Mancebo²

2016

BRN

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Mechanical ventilation is a common process in intensive care units. The weaning period has to be initiated as soon as possible because a delay in recognition that weaning can begin may prolong the duration of mechanical ventilation unnecessarily. The inappropriate management of weaning could influence outcomes; therefore, patients on weaning require continuous attention and intervention. The main objective of this review is to provide a description of the entire scenario and update on outcomes and common recommendations for the correct management of this complex process. The role of modern ventilator modes and non-invasive mechanical ventilation are discussed. Finally, the description and outcomes of a group of patients who have poor outcomes (prolonged weaning group), the importance of their identification, and suggestions for their general management are also presented. (BRN Rev. 2016;2:185-97)

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Safety and efficacy of a fully closed-loop control ventilation (IntelliVent-ASV®) in sedated ICU patients with acute respiratory failure: a prospective randomized crossover study

Abstract: In passive patients with acute respiratory failure, IntelliVent-ASV(®) was safe and able to ventilate patients with less pressure, volume and FiO(2) while producing the same results in terms of oxygenation.

Cited by 78 publications

References 26 publications

Recruitment Maneuvers and PEEP Titration

Recruitment Maneuvers and PEEP Titration

Automated Closed Loop Control of Inspired Oxygen Concentration

The Process of Weaning from Mechanical Ventilation

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