Automated mechanical ventilation using Adaptive Support Ventilation versus conventional ventilation including ventilator length of stay, mortality, and professional social aspects of adoption of new technology.

Ronald Sanderson, Denise Whitley, Christopher Batacan
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Abstract

Background Automation of mechanical ventilation allows for reduction of variation in patient management and has the potential to provide increased patient safety by strict adherence to computer driven ventilator protocols. Methods: A retrospective, observational study compared a group of 196 of general ICU patients managed exclusively on automated mechanical ventilation, adaptive support ventilation (ASV), to another group of 684 managed by usual, non-automated mechanical ventilation (No ASV). The data was collected in a unique access database designed to collect data for assessment of mechanical ventilation outcomes in a small medical center ICU. Results: The length of ventilator stay was non-significant between both groups, (81.7 ± 35.2 hours) in the ASV group; vs. (94.1 ± 35.1 hours) in the No ASV. Percent mortality was significantly less in the ASV group, 8.6% compared to 27.3% in the No ASV. Conclusion: Automated ventilation appears to be a safe ventilator strategy; however, cause effect relationships cannot be determined without further, more sophisticated studies. Keywords: Closed loop ventilation, ASV, Ventilator length of stay, Percent minute ventilation
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使用自适应支持通气与传统通气的自动机械通气,包括呼吸机停留时间、死亡率和采用新技术的专业社会方面。
背景:机械通气的自动化可以减少患者管理的变化,并有可能通过严格遵守计算机驱动的呼吸机协议来提高患者的安全性。方法:一项回顾性观察性研究比较了196名完全采用自动机械通气、适应性支持通气(ASV)治疗的普通ICU患者与684名采用常规非自动机械通气(无ASV)的患者。数据收集在一个独特的访问数据库中,该数据库旨在收集数据,用于评估小型医疗中心ICU的机械通气结果。结果:两组呼吸机停留时间无显著性差异,ASV组为(81.7±35.2小时);而无ASV组为(94.1±35.1小时)。ASV组的死亡率显著降低,为8.6%,而无ASV组为27.3%。结论:自动通气是一种安全的呼吸机策略;然而,如果没有更深入、更复杂的研究,就无法确定因果关系。关键词:闭环通气,ASV,呼吸机停留时间,分钟通气百分比
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