Adaptive support ventilation for faster weaning in COPD: a randomised controlled trial

Adaptive support ventilation (ASV) is a closed-loop ventilation mode that can act both as pressure support ventilation (PSV) and pressure-controlled ventilation. Weaning with ASV shows promising results, mainly in post-cardiac surgery patients. The aim of the present randomised controlled study was...

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Bibliographic Details
Published in:	The European respiratory journal Vol. 38; no. 4; pp. 774 - 780
Main Authors:	KIRAKLI, C, OZDEMIR, I, UCAR, Z. Z, CIMEN, P, KEPIL, S, OZKAN, S. A
Format:	Journal Article
Language:	English
Published:	Leeds Maney 01-10-2011
Subjects:	Acute Disease Aged Airway Extubation - standards APACHE Biological and medical sciences Chronic obstructive pulmonary disease, asthma Female Humans Intensive Care Units - standards Kaplan-Meier Estimate Male Medical sciences Middle Aged Pneumology Positive-Pressure Respiration - methods Positive-Pressure Respiration - standards Pulmonary Disease, Chronic Obstructive - complications Pulmonary Disease, Chronic Obstructive - therapy Respiratory Insufficiency - etiology Respiratory Insufficiency - therapy Time Factors Tracheostomy - standards Ventilator Weaning - methods Ventilator Weaning - standards Lung disease Chronic Support Respiratory disease Weaning Bronchus disease Chronic obstructive pulmonary disease Obstructive pulmonary disease Artificial ventilation Mechanical ventilation Intensive care unit Pneumology
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Summary:	Adaptive support ventilation (ASV) is a closed-loop ventilation mode that can act both as pressure support ventilation (PSV) and pressure-controlled ventilation. Weaning with ASV shows promising results, mainly in post-cardiac surgery patients. The aim of the present randomised controlled study was to test the hypothesis that weaning with ASV could reduce the weaning duration in patients with chronic obstructive pulmonary disease (COPD) when compared with PSV. From among 435 COPD patients admitted to the intensive care unit (ICU) during a 20-month period, 97 were enrolled. Patients were assigned at random to either ASV or PSV as a weaning mode. Compared with PSV, ASV provided shorter weaning times (median 24 (interquartile range 20-62) h versus 72 (24-144) h, p=0.041) with similar weaning success rates (35 out of 49 for ASV and 33 out of 48 for PSV). Length of stay in the ICU was also shorter with ASV but the difference was not statistically significant. This study suggests that ASV may be used in the weaning of COPD patients with the advantage of shorter weaning times. Further studies are needed to investigate the role and potential advantages of ASV in the weaning period of different patient groups.
Bibliography:	ObjectType-Article-2 SourceType-Scholarly Journals-1 ObjectType-News-1 ObjectType-Feature-3 content type line 23
ISSN:	0903-1936 1399-3003
DOI:	10.1183/09031936.00081510