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. 2008 Jan;34(1):75-81.
doi: 10.1007/s00134-007-0847-0. Epub 2007 Sep 11.

Automatic selection of breathing pattern using adaptive support ventilation

Jean-Michel Arnal  1 , Marc Wysocki, Cyril Nafati, Stéphane Donati, Isabelle Granier, Gaëlle Corno, Jacques Durand-Gasselin
Affiliations

Automatic selection of breathing pattern using adaptive support ventilation

Jean-Michel Arnal et al. Intensive Care Med. 2008 Jan.

Abstract

Objective: In a cohort of mechanically ventilated patients to compare the automatic tidal volume (VT)-respiratory rate (RR) combination generated by adaptive support ventilation (ASV) for various lung conditions.

Design and setting: Prospective observational cohort study in the 11-bed medicosurgical ICU of a general hospital.

Patients: 243 patients receiving 1327 days of invasive ventilation on ASV.

Measurements: Daily collection of ventilator settings, breathing pattern, arterial blood gases, and underlying clinical respiratory conditions categorized as: normal lungs, ALI/ARDS, COPD, chest wall stiffness, or acute respiratory failure.

Results: Overall the respiratory mechanics differed significantly with the underlying conditions. In passive patients ASV delivered different VT-RR combinations based on the underlying condition, providing higher VT and lower RR in COPD than in ALI/ARDS: 9.3ml/kg (8.2-10.8) predicted body weight (PBW) and 13 breaths/min (11-16) vs. 7.6ml/kg (6.7-8.8) PBW and 18 breaths/min (16-22). In patients actively triggering the ventilator the VT-RR combinations did not differ between COPD, ALI/ARDS, and normal lungs.

Conclusions: ASV selects different VT-RR combinations based on respiratory mechanics in passive, mechanically ventilated patients.

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