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Intensive Care Medicine

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01-04-2007 | Original

Automatic adjustment of noninvasive pressure support with a bilevel home ventilator in patients with acute respiratory failure: a feasibility study

Authors: Anne Battisti, Didier Tassaux, David Bassin, Philippe Jolliet

Published in: Intensive Care Medicine | Issue 4/2007

Abstract

Objective

To test the feasibility of applying noninvasive ventilation (NIV) using a prototype algorithm implemented in a bilevel ventilation device designed to adjust pressure support (PS) to maintain a clinician-set alveolar ventilation in patients with acute respiratory failure after initial stabilization.

Design and setting

Prospective crossover interventional study in an intensive care unit, university hospital.

Patients

19 patients receiving NIV for acute hypercapnic respiratory failure (13 men, 6 women; mean age 70 ± 11 years).

Methods

The same bilevel ventilator was used with manually adjusted PS and with the automated algorithm (autoPS), set to maintain the same alveolar ventilation as in PS. Sequence (measurements at end of each period): (a) prior to initiating NIV (baseline 1); (b) 45 min with manually set PS; (c) 60 min without NIV; (d) 45 min with autoPS; (e) 60 min without NIV; (f) 45 min with manually set PS.

Results

The magnitude of decrease in PaCO₂ and increase in pH with autoPS was comparable to that of conventional PS, with the same alveolar ventilation and level of PS. No technical problem occurred in autoPS mode, and no NIV trial had to be discontinued because of patient discomfort.

Conclusions

These results suggest that the alveolar ventilation based automatic control of PS during NIV with a bilevel device is feasible and leads to beneficial effects in patients with acute respiratory failure comparable to those of manually set PS. Further studies should now explore the potential of this system over longer periods in patients with acute and chronic respiratory failure.

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Title: Automatic adjustment of noninvasive pressure support with a bilevel home ventilator in patients with acute respiratory failure: a feasibility study
Authors: Anne Battisti
Didier Tassaux
David Bassin
Philippe Jolliet
Publication date: 01-04-2007
Publisher: Springer-Verlag
Published in: Intensive Care Medicine / Issue 4/2007
Print ISSN: 0342-4642
Electronic ISSN: 1432-1238
DOI: https://doi.org/10.1007/s00134-007-0550-1

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Automatic adjustment of noninvasive pressure support with a bilevel home ventilator in patients with acute respiratory failure: a feasibility study

Abstract

Objective

Design and setting

Patients

Methods

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Objective

Design and setting

Patients

Methods

Results

Conclusions

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