Clinical effects of adaptive lung ventilation regime during weaning of mixed ICU patients

Abstract

Background. Weaning from mechanical ventilation (MV) became one of the main problems of intensive care unit (ICU) physicians. Choosing the optimal mode of MV, which make possible to accelerate the process of weaning the patient, remain unresolved. A promising direction is the use of new adaptive ventilation modes.

Objective. To compare the clinical efficacy of the iSV regimen with the traditional CPAP + PS (PSV) regimen in patients of a mixed ICU.

Design and methods. 45 patients (age 31–81) were examined. Patients were on prolonged MV from 5 to 28 days. In group 1 pressure support (PSV) mode was used to adapt to spontaneous breathing. Group 2 consisted of patients in whom adaptive ventilation (iSV) mode was used.

Results. Both modes of assisted ventilation provided effective respiratory support. In the PSV mode, on the 3rd and 5th days of weaning from MV, hypocapnia and a higher support by the pressure of spontaneous inspirations (PS) were noted. A higher daily energy requirement was revealed in PSV mode on day 3. The length of stay in ICU in iSV group was moderately decreased.

Conclusion. Assisted ventilation modes PSV and iSV are effective in adapting patients to spontaneous breathing after prolonged MV. The iSV mode appears to cause less respiratory stress compared to the PSV mode. Assisted ventilation in iSV versus PSV can possibly reduce ICU length of stay.