Usefulness of INTELLiVENT-ASV for postoperative ventilator-associated pneumonia: a case report

BACKGROUND: INTELLiVENT®-ASV (iASV) is a respiration mode on the Hamilton G5. The ventilator uses a closed-loop mechanism that automatically adjusts settings related to oxygenation and ventilation. CASE PRESENTATION: A 47-year-old man underwent reconstruction surgery with free musculocutaneous flap for tongue resection. After surgery, the patient entered the ICU, and the iASV, which automatically changed only the percent minute volume (%MV) in respiration mode, was selected. On the second day, ventilator-associated pneumonia (VAP) was diagnosed, and the antibiotic treatment was changed. Using the settings of the iASV, automated FiO2 and positive end-expiratory pressure (PEEP) control were added to the ventilator mode. The patient’s oxygenation was improved. CONCLUSIONS: In a patient who developed VAP after surgery, ventilation was continued using iASV, and automated changes in PEEP and FiO2 settings were successfully made according to the open lung strategy, under short-staffed circumstances.