Comparative analysis of fully automated vs. conventional ventilation in postoperative cardiac surgery patients: Impact on alarms, interventions, and nurse acceptance

IF 4.7 2区医学 Q1 NURSING Intensive and Critical Care Nursing Pub Date : 2025-08-01 Epub Date: 2025-02-11 DOI:10.1016/j.iccn.2025.103963

Lisan M.A.A. van Haren , Daphne L.J. Nabben , Carla Kloeze , Michiel A.C. Dekker , Tineke J.C. De Vries , Laura A. Buiteman-Kruizinga , Ary Serpa Neto , Tobias van Leijsen , Frederique Paulus , David M.P. van Meenen , Leon Montenij , Erik H.M. Korsten , Alexander J.G.H. Bindels , Arthur R. Bouwman , Marcus J. Schultz , Ashley J.R. De Bie Dekker

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Abstract

Objectives

To compare the number of alarms, interventions and nurses’ acceptance of automated ventilation with INTELLiVENT-ASV versus conventional ventilation strategy in patients receiving postoperative ventilation after cardiac surgery.

Methods

This preplanned secondary analysis of the ‘POSITiVE’ randomized clinical trial compared INTELLiVENT-ASV (automated ventilation) with conventional ventilation in postoperative cardiac surgery patients. The number of critical alarms and manual ventilator interventions were compared during the first three hours of ventilation or until extubation. Nurses’ acceptance was assessed using a Technology Acceptance Model 2-based questionnaire and a user acceptance score from 1 to 10.

Results

POSITiVE randomized 220 patients (109 to automated and 111 to conventional ventilation). The average number of critical alarms per monitoring hour was similar between the automated and conventional group (5.6 vs 5.7; p = 0.823). The automated group required fewer manual interventions per monitoring hour for both ventilation control (0.7 vs 1.9; p < 0.001) and alarm management (2.0 vs 2.8; p < 0.001). The automated ventilation mode scored higher for perceived usefulness (2.6 vs 2.1; p < 0.001) and user acceptance (8.0 vs 7.0; p < 0.001), but similar for perceived ease of use.

Conclusions

Automated ventilation for postoperative cardiac surgery patients had similar alarm frequencies as conventional ventilation, but reduced the number of interventions and showed higher nurses’ acceptance, indicating its potential to optimize patient care and reduce nurses’ workload.

Implications for Clinical Practice

Our findings suggest that automated ventilation modes like INTELLiVENT-ASV can reduce the frequency of manual interventions and improve nurses’ acceptance, which may help alleviate nurses’ workload for postoperative cardiac surgery patients.

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心脏手术患者术后全自动与常规通气的比较分析：对报警、干预和护士接受程度的影响

目的比较心脏手术后患者采用INTELLiVENT-ASV自动通气与常规通气策略的报警次数、干预措施和护士接受程度。方法对“POSITiVE”随机临床试验进行预先计划的二次分析，比较INTELLiVENT-ASV（自动通气）和常规通气对心脏手术后患者的影响。在通气的前三个小时或拔管前，比较了紧急警报和人工呼吸机干预的次数。使用基于技术接受模型2的问卷和用户接受评分从1到10来评估护士的接受程度。结果随机220例患者，其中自动通气109例，常规通气111例。自动化组和常规组每监测小时的平均紧急警报次数相似(5.6 vs 5.7；p = 0.823)。自动化组每监测小时在通气控制方面需要更少的人工干预(0.7 vs 1.9；p & lt;0.001)和报警管理(2.0 vs 2.8；p & lt;0.001)。自动通风模式在感知有用性方面得分更高(2.6 vs 2.1；p & lt;0.001)和用户接受度(8.0 vs 7.0；p & lt;0.001)，但感知易用性相似。结论心脏手术后患者自动通气的报警频率与常规通气相似，但减少了干预次数，护士接受度更高，具有优化患者护理和减轻护士工作量的潜力。我们的研究结果表明，像INTELLiVENT-ASV这样的自动通气模式可以减少人工干预的频率，提高护士的接受度，这可能有助于减轻护士对心脏手术后患者的工作量。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Intensive and Critical Care Nursing NURSING-

CiteScore

6.30

自引率

15.10%

发文量

144

审稿时长

57 days

期刊介绍： The aims of Intensive and Critical Care Nursing are to promote excellence of care of critically ill patients by specialist nurses and their professional colleagues; to provide an international and interdisciplinary forum for the publication, dissemination and exchange of research findings, experience and ideas; to develop and enhance the knowledge, skills, attitudes and creative thinking essential to good critical care nursing practice. The journal publishes reviews, updates and feature articles in addition to original papers and significant preliminary communications. Articles may deal with any part of practice including relevant clinical, research, educational, psychological and technological aspects.