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Intensive Care Medicine
Published in: Intensive Care Medicine 3/2013

01-03-2013 | Original

Evaluation of fully automated ventilation: a randomized controlled study in post-cardiac surgery patients

Authors: François Lellouche, Pierre-Alexandre Bouchard, Serge Simard, Erwan L’Her, Marc Wysocki

Published in: Intensive Care Medicine | Issue 3/2013

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Abstract

Purpose

Discrepancies between the demand and availability of clinicians to care for mechanically ventilated patients can be anticipated due to an aging population and to increasing severity of illness. The use of closed-loop ventilation provides a potential solution. The aim of the study was to evaluate the safety of a fully automated ventilator.

Methods

We conducted a randomized controlled trial comparing automated ventilation (AV) and protocolized ventilation (PV) in 60 ICU patients after cardiac surgery. In the PV group, tidal volume, respiratory rate, FiO2 and positive end-expiratory pressure (PEEP) were set according to the local hospital protocol based on currently available guidelines. In the AV group, only sex, patient height and a maximum PEEP level of 10 cmH2O were set. The primary endpoint was the duration of ventilation within a “not acceptable” range of tidal volume. Zones of optimal, acceptable and not acceptable ventilation were based on several respiratory parameters and defined a priori.

Results

The patients were assigned equally to each group, 30 to PV and 30 to AV. The percentage of time within the predefined zones of optimal, acceptable and not acceptable ventilation were 12 %, 81 %, and 7 % respectively with PV, and 89.5 %, 10 % and 0.5 % with AV (P < 0.001). There were 148 interventions required during PV compared to only 5 interventions with AV (P < 0.001).

Conclusion

Fully AV was safe in hemodynamically stable patients immediately following cardiac surgery. In addition to a reduction in the number of interventions, the AV system maintained patients within a predefined target range of optimal ventilation.
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Metadata
Title
Evaluation of fully automated ventilation: a randomized controlled study in post-cardiac surgery patients
Authors
François Lellouche
Pierre-Alexandre Bouchard
Serge Simard
Erwan L’Her
Marc Wysocki
Publication date
01-03-2013
Publisher
Springer-Verlag
Published in
Intensive Care Medicine / Issue 3/2013
Print ISSN: 0342-4642
Electronic ISSN: 1432-1238
DOI
https://doi.org/10.1007/s00134-012-2799-2

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