Effect of automated versus conventional ventilation on mechanical power of ventilation-A randomized crossover clinical trial
Mechanical power of ventilation, a summary parameter reflecting the energy transferred from the ventilator to the respiratory system, has associations with outcomes. INTELLiVENT-Adaptive Support Ventilation is an automated ventilation mode that changes ventilator settings according to algorithms tha...
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Published in | PloS one Vol. 19; no. 7; p. e0307155 |
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Main Authors | , , , , , , , , , , |
Format | Journal Article |
Language | English |
Published |
United States
Public Library of Science
30.07.2024
Public Library of Science (PLoS) |
Subjects | |
Online Access | Get full text |
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Summary: | Mechanical power of ventilation, a summary parameter reflecting the energy transferred from the ventilator to the respiratory system, has associations with outcomes. INTELLiVENT-Adaptive Support Ventilation is an automated ventilation mode that changes ventilator settings according to algorithms that target a low work-and force of breathing. The study aims to compare mechanical power between automated ventilation by means of INTELLiVENT-Adaptive Support Ventilation and conventional ventilation in critically ill patients.
International, multicenter, randomized crossover clinical trial in patients that were expected to need invasive ventilation > 24 hours. Patients were randomly assigned to start with a 3-hour period of automated ventilation or conventional ventilation after which the alternate ventilation mode was selected. The primary outcome was mechanical power in passive and active patients; secondary outcomes included key ventilator settings and ventilatory parameters that affect mechanical power.
A total of 96 patients were randomized. Median mechanical power was not different between automated and conventional ventilation (15.8 [11.5-21.0] versus 16.1 [10.9-22.6] J/min; mean difference -0.44 (95%-CI -1.17 to 0.29) J/min; P = 0.24). Subgroup analyses showed that mechanical power was lower with automated ventilation in passive patients, 16.9 [12.5-22.1] versus 19.0 [14.1-25.0] J/min; mean difference -1.76 (95%-CI -2.47 to -10.34J/min; P < 0.01), and not in active patients (14.6 [11.0-20.3] vs 14.1 [10.1-21.3] J/min; mean difference 0.81 (95%-CI -2.13 to 0.49) J/min; P = 0.23).
In this cohort of unselected critically ill invasively ventilated patients, automated ventilation by means of INTELLiVENT-Adaptive Support Ventilation did not reduce mechanical power. A reduction in mechanical power was only seen in passive patients.
Clinicaltrials.gov (study identifier NCT04827927), April 1, 2021.
https://clinicaltrials.gov/study/NCT04827927?term=intellipower&rank=1. |
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Bibliography: | ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23 ObjectType-Undefined-3 INTELLiPOWER: ‘The Effect of Closed–loop versus Conventional Ventilation on Mechanical Power’ and a complete list of collaborative authors is provided in the Acknowledgments. Competing Interests: LBK received fees from Hamilton Medical for lecturing. MJS was part-time employed as a team leader of Research and New Technologies at Hamilton Medical from January 2022 till January 2023. The other authors declare no conflicts of interest. |
ISSN: | 1932-6203 1932-6203 |
DOI: | 10.1371/journal.pone.0307155 |