Articles

Intelligent ventilation in the intensive care unit

Sigal Sviri, Abed Bayya, Phillip D Levin, Rabia Khalaila, Ilana Stav, David M Linton

Abstract


Objectives. Automated, microprocessor-controlled, closed-loop mechanical ventilation has been used in our Medical Intensive Care Unit (MICU) at the Hadassah Hebrew-University Medical Center for the past 15 years; for 10 years it has been the primary (preferred) ventilator modality.

Design and setting. We describe our clinical experience with adaptive support ventilation (ASV) over a 6-year period, during which time ASV-enabled ventilators became more readily available and were used as the primary (preferred) ventilators for all patients admitted to the MICU.

Results. During the study period, 1 220 patients were ventilated in the MICU. Most patients (84%) were ventilated with ASV on admission. The median duration of ventilation with ASV was 6 days. The weaning success rate was 81%, and tracheostomy was required in 13%. Sixty-eight patients (6%) with severe hypoxia and high inspiratory pressures were placed on pressure-controlled ventilation, in most cases to satisfy a technical requirement for precise and conservative administration of inhaled nitric oxide.
The overall pneumothorax rate was less than 3%, and less than 1% of patients who were ventilated only using ASV developed pneumothorax.

Conclusions. ASV is a safe and acceptable mode of ventilation for complicated medical patients, with a lower than usual ventilation complication rate.

Authors' affiliations

Sigal Sviri, Medical Intensive Care Unit, Hadassah-Hebrew University Medical Center, Jerusalem, Israel

Abed Bayya, Medical Intensive Care Unit, Hadassah-Hebrew University Medical Center, Jerusalem, Israel

Phillip D Levin, General Intensive Care Unit, Hadassah-Hebrew University Medical Center, Jerusalem, Israel.

Rabia Khalaila, Medical ICU, Hadassah-Hebrew University Medical Center, Jerusalem, Israel 91120

Ilana Stav, Medical ICU, Hadassah-Hebrew University Medical Center, Jerusalem, Israel 91120

David M Linton, Medical ICU, Hadassah-Hebrew University Medical Center, Jerusalem, Israel 91120

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Keywords

adaptive support ventilation, mechanical ventilation, complications, weaning

Cite this article

Southern African Journal of Critical Care 2012;28(1):6-14.

Article History

Date submitted: 2011-12-18
Date published: 2012-07-09

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