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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

Jean-Michel Arnal| Marc Wysocki| Dominik Novotni| Didier Demory| Ricardo Lopez| Stéphane Donati| Isabelle Granier| Gaëlle Corno| Jacques Durand-Gasselin
Original
Volume 38, Issue 5 / May , 2012

Pages 781 - 787

Abstract

Purpose

IntelliVent-ASV® is a development of adaptive support ventilation (ASV) that automatically adjusts ventilation and oxygenation parameters. This study assessed the safety and efficacy of IntelliVent-ASV® in sedated intensive care unit (ICU) patients with acute respiratory failure.

Methods

This prospective randomized crossover comparative study was conducted in a 12-bed ICU in a general hospital. Two periods of 2 h of ventilation in randomly applied ASV or IntelliVent-ASV® were compared in 50 sedated, passively ventilated patients. Tidal volume (VT), respiratory rate (RR), inspiratory pressure (PINSP), SpO2 and ETCO2 were continuously monitored and recorded breath by breath. Mean values over the 2-h period were calculated. Respiratory mechanics, plateau pressure (PPLAT) and blood gas exchanges were measured at the end of each period.

Results

There was no safety issue requiring premature interruption of IntelliVent-ASV®. Minute ventilation (MV) and VT decreased from 7.6 (6.5–9.5) to 6.8 (6.0–8.0) L/min (p < 0.001) and from 8.3 (7.8–9.0) to 8.1 (7.7–8.6) mL/kg PBW (p = 0.003) during IntelliVent-ASV® as compared to ASV. PPLAT and FiO2 decreased from 24 (20–29) to 20 (19–25) cmH2O (p = 0.005) and from 40 (30–50) to 30 (30–39) % (p < 0.001) during IntelliVent-ASV® as compared to ASV. RR, PINSP, and PEEP decreased as well during IntelliVent-ASV® as compared to ASV. Respiratory mechanics, pH, PaO2 and PaO2/FiO2 ratio were not different but PaCO2 was slightly higher during IntelliVent-ASV® as compared to ASV.

Conclusions

In passive patients with acute respiratory failure, IntelliVent-ASV® was safe and able to ventilate patients with less pressure, volume and FiO2 while producing the same results in terms of oxygenation.

Keywords

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