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Comparison of 3 modes of automated weaning from mechanical ventilation: a bench study.

Abstract：

PURPOSE:Automated weaning modes are available in some mechanical ventilators, but no studies compared them hitherto. We compared the performance of 3 automated modes under standard and challenging situations. METHODS:We used a lung simulator to compare 3 automated modes, adaptive support ventilation (ASV), mandatory rate ventilation (MRV), and Smartcare, in 6 situations, weaning success, weaning failure, weaning success with extreme anxiety, weaning success with Cheyne-Stokes, weaning success with irregular breathing, and weaning failure with ineffective efforts. RESULTS:The 3 modes correctly recognized the situations of weaning success and failure, even when anxiety or irregular breathing were present but incorrectly recognized weaning success with Cheyne-Stokes. MRV incorrectly recognized weaning failure with ineffective efforts. Time to pressure support (PS) stabilization was shorter for ASV (1-2 minutes for all situations) and MRV (1-7 minutes) than for Smartcare (8-78 minutes). ASV had higher rates of PS oscillations per 5 minutes (4-15), compared with Smartcare (0-1) and MRV (0-12), except when extreme anxiety was present. CONCLUSIONS:Smartcare, ASV, and MRV were equally able to recognize weaning success and failure, despite the presence of anxiety or irregular breathing but performed incorrectly in the presence of Cheyne-Stokes. PS behavior over the time differs among modes, with ASV showing larger and more frequent PS oscillations over the time. Clinical studies are needed to confirm our results.

journal_name

J Crit Care

journal_title

Journal of critical care

authors

Morato JB,Sakuma MT,Ferreira JC,Caruso P

doi

10.1016/j.jcrc.2011.12.021

subject

Has Abstract

pub_date

2012-12-01 00:00:00

pages

741.e1-8

issue

6

eissn

0883-9441

issn

1557-8615

pii

S0883-9441(12)00009-3

journal_volume

27

pub_type

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