Abstract
Introduction: The present study is a pilot prospective safety evaluation of a new closed loop computerised protocol on ventilation and oxygenation in stable, spontaneously breathing children weighing more than 7 kg, during the weaning phase of mechanical ventilation.Methods: Mechanically ventilated children ready to start the weaning process were ventilated for five periods of 60 minutes in the following order: pressure support ventilation, adaptive support ventilation (ASV), ASV plus a ventilation controller (ASV-CO 2), ASV-CO 2 plus an oxygenation controller (ASV-CO 2-O 2) and pressure support ventilation again. Based on breath-by-breath analysis, the percentage of time with normal ventilation as defined by a respiratory rate between 10 and 40 breaths/minute, tidal volume > 5 ml/kg predicted body weight and end-tidal CO 2 between 25 and 55 mmHg was determined. The number of manipulations and changes on the ventilator were also recorded.Results: Fifteen children, median aged 45 months, were investigated. No adverse event and no premature protocol termination were reported. ASV-CO 2 and ASV-CO 2-O 2 kept the patients within normal ventilation for, respectively, 94% (91 to 96%) and 94% (87 to 96%) of the time. The tidal volume, respiratory rate, peak inspiratory airway pressure and minute ventilation were equivalent for all modalities, although there were more automatic setting changes in ASV-CO 2 and ASV-CO 2-O 2. Positive end-expiratory pressure modifications by ASV-CO 2-O 2 require further investigation.Conclusion: Over the short study period and in this specific population, ASV-CO 2 and ASV-CO 2-O 2 were safe and kept the patient under normal ventilation most of the time. Further research is needed, especially for positive end-expiratory pressure modifications by ASV-CO 2-O 2.Trial registration: ClinicalTrials.gov: NCT01095406.
| Original language | English (US) |
|---|---|
| Article number | R85 |
| Journal | Critical Care |
| Volume | 16 |
| Issue number | 3 |
| DOIs | |
| State | Published - May 16 2012 |
| Externally published | Yes |
Fingerprint
ASJC Scopus subject areas
- Critical Care and Intensive Care Medicine
- Medicine(all)
Cite this
A pilot prospective study on closed loop controlled ventilation and oxygenation in ventilated children during the weaning phase. / Jouvet, Philippe; Eddington, Allen; Payen, Valérie; Bordessoule, Alice; Emeriaud, Guillaume; Gasco, Ricardo L.; Wysocki, Marc.
In: Critical Care, Vol. 16, No. 3, R85, 16.05.2012.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - A pilot prospective study on closed loop controlled ventilation and oxygenation in ventilated children during the weaning phase
AU - Jouvet, Philippe
AU - Eddington, Allen
AU - Payen, Valérie
AU - Bordessoule, Alice
AU - Emeriaud, Guillaume
AU - Gasco, Ricardo L.
AU - Wysocki, Marc
PY - 2012/5/16
Y1 - 2012/5/16
N2 - Introduction: The present study is a pilot prospective safety evaluation of a new closed loop computerised protocol on ventilation and oxygenation in stable, spontaneously breathing children weighing more than 7 kg, during the weaning phase of mechanical ventilation.Methods: Mechanically ventilated children ready to start the weaning process were ventilated for five periods of 60 minutes in the following order: pressure support ventilation, adaptive support ventilation (ASV), ASV plus a ventilation controller (ASV-CO 2), ASV-CO 2 plus an oxygenation controller (ASV-CO 2-O 2) and pressure support ventilation again. Based on breath-by-breath analysis, the percentage of time with normal ventilation as defined by a respiratory rate between 10 and 40 breaths/minute, tidal volume > 5 ml/kg predicted body weight and end-tidal CO 2 between 25 and 55 mmHg was determined. The number of manipulations and changes on the ventilator were also recorded.Results: Fifteen children, median aged 45 months, were investigated. No adverse event and no premature protocol termination were reported. ASV-CO 2 and ASV-CO 2-O 2 kept the patients within normal ventilation for, respectively, 94% (91 to 96%) and 94% (87 to 96%) of the time. The tidal volume, respiratory rate, peak inspiratory airway pressure and minute ventilation were equivalent for all modalities, although there were more automatic setting changes in ASV-CO 2 and ASV-CO 2-O 2. Positive end-expiratory pressure modifications by ASV-CO 2-O 2 require further investigation.Conclusion: Over the short study period and in this specific population, ASV-CO 2 and ASV-CO 2-O 2 were safe and kept the patient under normal ventilation most of the time. Further research is needed, especially for positive end-expiratory pressure modifications by ASV-CO 2-O 2.Trial registration: ClinicalTrials.gov: NCT01095406.
AB - Introduction: The present study is a pilot prospective safety evaluation of a new closed loop computerised protocol on ventilation and oxygenation in stable, spontaneously breathing children weighing more than 7 kg, during the weaning phase of mechanical ventilation.Methods: Mechanically ventilated children ready to start the weaning process were ventilated for five periods of 60 minutes in the following order: pressure support ventilation, adaptive support ventilation (ASV), ASV plus a ventilation controller (ASV-CO 2), ASV-CO 2 plus an oxygenation controller (ASV-CO 2-O 2) and pressure support ventilation again. Based on breath-by-breath analysis, the percentage of time with normal ventilation as defined by a respiratory rate between 10 and 40 breaths/minute, tidal volume > 5 ml/kg predicted body weight and end-tidal CO 2 between 25 and 55 mmHg was determined. The number of manipulations and changes on the ventilator were also recorded.Results: Fifteen children, median aged 45 months, were investigated. No adverse event and no premature protocol termination were reported. ASV-CO 2 and ASV-CO 2-O 2 kept the patients within normal ventilation for, respectively, 94% (91 to 96%) and 94% (87 to 96%) of the time. The tidal volume, respiratory rate, peak inspiratory airway pressure and minute ventilation were equivalent for all modalities, although there were more automatic setting changes in ASV-CO 2 and ASV-CO 2-O 2. Positive end-expiratory pressure modifications by ASV-CO 2-O 2 require further investigation.Conclusion: Over the short study period and in this specific population, ASV-CO 2 and ASV-CO 2-O 2 were safe and kept the patient under normal ventilation most of the time. Further research is needed, especially for positive end-expiratory pressure modifications by ASV-CO 2-O 2.Trial registration: ClinicalTrials.gov: NCT01095406.
UR - http://www.scopus.com/inward/record.url?scp=84861864666&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84861864666&partnerID=8YFLogxK
U2 - 10.1186/cc11343
DO - 10.1186/cc11343
M3 - Article
C2 - 22591622
AN - SCOPUS:84861864666
VL - 16
JO - Critical Care
JF - Critical Care
SN - 1466-609X
IS - 3
M1 - R85
ER -