Eine Plattform für die Wissenschaft: Bauingenieurwesen, Architektur und Urbanistik
Eine Plattform für die Wissenschaft: Bauingenieurwesen, Architektur und Urbanistik
Closed-Loop Versus Conventional Mechanical Ventilation in COVID-19 ARDS
BACKGROUND: Lung-protective ventilation is key in bridging patients suffering from COVID-19 acute respiratory distress syndrome (ARDS) to recovery. However, resource and personnel limitations during pandemics complicate the implementation of lung-protective protocols. Automated ventilation modes may prove decisive in these settings enabling higher degrees of lung-protective ventilation than conventional modes. METHOD: Prospective study at a Swiss university hospital. Critically ill, mechanically ventilated COVID-19 ARDS patients were allocated, by study-blinded coordinating staff, to either closed-loop or conventional mechanical ventilation, based on mechanical ventilator availability. Primary outcome was the overall achieved percentage of lung-protective ventilation in closed-loop versus conventional mechanical ventilation, assessed minute-by-minute, during the initial 7 days and overall mechanical ventilation time. Lung-protective ventilation was defined as the combined target of tidal volume <8 ml per kg of ideal body weight, dynamic driving pressure <15 cmH$_{2}$O, peak pressure <30 cmH$_{2}$O, peripheral oxygen saturation ≥88% and dynamic mechanical power <17 J/min. RESULTS: Forty COVID-19 ARDS patients, accounting for 1,048,630 minutes (728 days) of cumulative mechanical ventilation, allocated to either closed-loop (n = 23) or conventional ventilation (n = 17), presenting with a median paO$_{2}$/ FiO$_{2}$ ratio of 92 [72-147] mmHg and a static compliance of 18 [11-25] ml/cmH$_{2}$O, were mechanically ventilated for 11 [4-25] days and had a 28-day mortality rate of 20%. During the initial 7 days of mechanical ventilation, patients in the closed-loop group were ventilated lung-protectively for 65% of the time versus 38% in the conventional group (Odds Ratio, 1.79; 95% CI, 1.76-1.82; P < 0.001) and for 45% versus 33% of overall mechanical ventilation time (Odds Ratio, 1.22; 95% CI, 1.21-1.23; P < 0.001). CONCLUSION: Among critically ill, mechanically ventilated COVID-19 ARDS patients during ...
Closed-Loop Versus Conventional Mechanical Ventilation in COVID-19 ARDS
BACKGROUND: Lung-protective ventilation is key in bridging patients suffering from COVID-19 acute respiratory distress syndrome (ARDS) to recovery. However, resource and personnel limitations during pandemics complicate the implementation of lung-protective protocols. Automated ventilation modes may prove decisive in these settings enabling higher degrees of lung-protective ventilation than conventional modes. METHOD: Prospective study at a Swiss university hospital. Critically ill, mechanically ventilated COVID-19 ARDS patients were allocated, by study-blinded coordinating staff, to either closed-loop or conventional mechanical ventilation, based on mechanical ventilator availability. Primary outcome was the overall achieved percentage of lung-protective ventilation in closed-loop versus conventional mechanical ventilation, assessed minute-by-minute, during the initial 7 days and overall mechanical ventilation time. Lung-protective ventilation was defined as the combined target of tidal volume <8 ml per kg of ideal body weight, dynamic driving pressure <15 cmH$_{2}$O, peak pressure <30 cmH$_{2}$O, peripheral oxygen saturation ≥88% and dynamic mechanical power <17 J/min. RESULTS: Forty COVID-19 ARDS patients, accounting for 1,048,630 minutes (728 days) of cumulative mechanical ventilation, allocated to either closed-loop (n = 23) or conventional ventilation (n = 17), presenting with a median paO$_{2}$/ FiO$_{2}$ ratio of 92 [72-147] mmHg and a static compliance of 18 [11-25] ml/cmH$_{2}$O, were mechanically ventilated for 11 [4-25] days and had a 28-day mortality rate of 20%. During the initial 7 days of mechanical ventilation, patients in the closed-loop group were ventilated lung-protectively for 65% of the time versus 38% in the conventional group (Odds Ratio, 1.79; 95% CI, 1.76-1.82; P < 0.001) and for 45% versus 33% of overall mechanical ventilation time (Odds Ratio, 1.22; 95% CI, 1.21-1.23; P < 0.001). CONCLUSION: Among critically ill, mechanically ventilated COVID-19 ARDS patients during ...
Closed-Loop Versus Conventional Mechanical Ventilation in COVID-19 ARDS
Wendel Garcia, Pedro David (Autor:in) / Hofmaenner, Daniel Andrea (Autor:in) / Brugger, Silvio D (Autor:in) / Acevedo, Claudio Tirso (Autor:in) / Bartussek, Jan (Autor:in) / Camen, Giovanni (Autor:in) / Bader, Patrick Raphael (Autor:in) / Bruellmann, Gregor (Autor:in) / Kattner, Johannes (Autor:in) / Ganter, Christoph (Autor:in)
01.10.2021
Wendel Garcia, Pedro David; Hofmaenner, Daniel Andrea; Brugger, Silvio D; Acevedo, Claudio Tirso; Bartussek, Jan; Camen, Giovanni; Bader, Patrick Raphael; Bruellmann, Gregor; Kattner, Johannes; Ganter, Christoph; Schuepbach, Reto Andreas; Buehler, Philipp Karl (2021). Closed-Loop Versus Conventional Mechanical Ventilation in COVID-19 ARDS. Journal of intensive care medicine, 36(10):1184-1193.
Aufsatz (Zeitschrift)
Elektronische Ressource
Englisch
DDC:
690
Closed or open windows with mechanical ventilation
| Engineering Index Backfile | 1912
| British Library Conference Proceedings | 1991
| BASE | 2010