Effect of INTELLiVENT-ASV versus Conventional Ventilation on Ventilation Intensity in Patients with COVID-19 ARDS—An Observational Study

Journal of Clinical Medicine

Frederique Paulus¹  Michela Botta¹  Ary Serpa Neto¹  Marcus J. Schultz¹  Laura A. Buiteman-Kruizinga²  Pim L.J. van der Heiden²  Matthijs D. Kruizinga³  Hassan E. Mkadmi⁴ 

[1] Department of Intensive Care, Amsterdam University Medical Centers, Location ‘AMC’, 1105 AZ Amsterdam, The Netherlands;Department of Intensive Care, Reinier de Graaf Hospital, 2625 AD Delft, The Netherlands;Department of Pediatrics, Juliana Children’s Hospital, 2545 AA The Hague, The Netherlands;Department of Research, Reinier de Graaf Hospital, 2625 AD Delft, The Netherlands;

关键词: COVID-19;    ARDS;    automated ventilation;    closed-loop ventilation;    INTELLiVENT-ASV;    intensity of ventilation;   

DOI  :  10.3390/jcm10225409

来源: DOAJ

【 摘 要 】

Driving pressure (ΔP) and mechanical power (MP) are associated with outcomes in critically ill patients, irrespective of the presence of Acute Respiratory Distress Syndrome (ARDS). INTELLiVENT-ASV, a fully automated ventilatory mode, controls the settings that affect ΔP and MP. This study compared the intensity of ventilation (ΔP and MP) with INTELLiVENT-ASV versus conventional ventilation in a cohort of COVID-19 ARDS patients in two intensive care units in the Netherlands. The coprimary endpoints were ΔP and MP before and after converting from conventional ventilation to INTELLiVENT-ASV. Compared to conventional ventilation, INTELLiVENT-ASV delivered ventilation with a lower ΔP and less MP. With conventional ventilation, ΔP was 13 cmH₂O, and MP was 21.5 and 24.8 J/min, whereas with INTELLiVENT-ASV, ΔP was 11 and 10 cmH₂O (mean difference –2 cm H2O (95 %CI –2.5 to –1.2 cm H₂O), p < 0.001) and MP was 18.8 and 17.5 J/min (mean difference –7.3 J/Min (95% CI –8.8 to –5.8 J/min), p < 0.001). Conversion from conventional ventilation to INTELLiVENT-ASV resulted in a lower intensity of ventilation. These findings may favor the use of INTELLiVENT-ASV in COVID-19 ARDS patients, but future studies remain needed to see if the reduction in the intensity of ventilation translates into clinical benefits.

【 授权许可】

Unknown