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Comparison of adaptive support ventilation and synchronized intermittent mandatory ventilation in patients with acute respiratory distress syndrome: A randomized clinical trial

BACKGROUND: Suitable mechanical ventilation strategies can reduce the incidence and severity of ventilator-associated lung injury in patients with acute respiratory distress syndrome (ARDS). In this study, the effects of adaptive support ventilation (ASV) and synchronized intermittent mandatory vent...

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Autores principales: Alikiaii, Babak, Abbasi, Saeed, Yari, Hamideh, Akbari, Mojtaba, Kashefi, Parviz
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Wolters Kluwer - Medknow 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8943583/
https://www.ncbi.nlm.nih.gov/pubmed/35342439
http://dx.doi.org/10.4103/jrms.JRMS_905_18
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author Alikiaii, Babak
Abbasi, Saeed
Yari, Hamideh
Akbari, Mojtaba
Kashefi, Parviz
author_facet Alikiaii, Babak
Abbasi, Saeed
Yari, Hamideh
Akbari, Mojtaba
Kashefi, Parviz
author_sort Alikiaii, Babak
collection PubMed
description BACKGROUND: Suitable mechanical ventilation strategies can reduce the incidence and severity of ventilator-associated lung injury in patients with acute respiratory distress syndrome (ARDS). In this study, the effects of adaptive support ventilation (ASV) and synchronized intermittent mandatory ventilation (SIMV) on respiratory parameters and arterial blood gases (ABGs) parameters were compared in ARDS patients. MATERIALS AND METHODS: Twenty-four patients were randomly divided into two groups of ASV and SIMV. Patients were followed up for 3 days, and respiratory parameters including rapid shallow breathing index (RSBI), spontaneous breathing rate (SBR), minute volume, and peak inspiratory pressure (PIP) as the primary outcomes and ABG parameters including PaO(2), FiO(2), PaCO(2), HCO(3), and PaO(2)/FiO(2) ratio as the secondary outcomes were measured. RESULTS: PIP in patients in the SIMV group on the 1(st) day (P = 0.013), 2(nd) day (P = 0.001), and 3(rd) day (P = 0.004) was statistically significantly more compared to those in patients in the ASV group. RSBI, SBR, and minute volume between the ASV and SIMV groups during the 3 days were not statistically significantly different (P > 0.05). The mean arterial blood pressure, heart rate, PaO(2), and PH between both groups were similar (P > 0.05). At the end of the 2(nd) and 3(rd) days, the level of FiO(2) and PaCO(2) in ASV was significantly lower than those in ASV group. HCO(3) in each of the 3 days in the ASV group was statistically significantly lower than that in the SIMV group (P < 0.050). PaO(2)/FiO(2) ratio in patients in the ASV group in the 3 days was statistically significantly higher than that in the SIMV group (P < 0.050). CONCLUSION: By reducing PIP and improving oxygenation and ABG parameters, ASV mode may be a safe and feasible mode during mechanical ventilation in patients with ARDS.
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spelling pubmed-89435832022-03-25 Comparison of adaptive support ventilation and synchronized intermittent mandatory ventilation in patients with acute respiratory distress syndrome: A randomized clinical trial Alikiaii, Babak Abbasi, Saeed Yari, Hamideh Akbari, Mojtaba Kashefi, Parviz J Res Med Sci Original Article BACKGROUND: Suitable mechanical ventilation strategies can reduce the incidence and severity of ventilator-associated lung injury in patients with acute respiratory distress syndrome (ARDS). In this study, the effects of adaptive support ventilation (ASV) and synchronized intermittent mandatory ventilation (SIMV) on respiratory parameters and arterial blood gases (ABGs) parameters were compared in ARDS patients. MATERIALS AND METHODS: Twenty-four patients were randomly divided into two groups of ASV and SIMV. Patients were followed up for 3 days, and respiratory parameters including rapid shallow breathing index (RSBI), spontaneous breathing rate (SBR), minute volume, and peak inspiratory pressure (PIP) as the primary outcomes and ABG parameters including PaO(2), FiO(2), PaCO(2), HCO(3), and PaO(2)/FiO(2) ratio as the secondary outcomes were measured. RESULTS: PIP in patients in the SIMV group on the 1(st) day (P = 0.013), 2(nd) day (P = 0.001), and 3(rd) day (P = 0.004) was statistically significantly more compared to those in patients in the ASV group. RSBI, SBR, and minute volume between the ASV and SIMV groups during the 3 days were not statistically significantly different (P > 0.05). The mean arterial blood pressure, heart rate, PaO(2), and PH between both groups were similar (P > 0.05). At the end of the 2(nd) and 3(rd) days, the level of FiO(2) and PaCO(2) in ASV was significantly lower than those in ASV group. HCO(3) in each of the 3 days in the ASV group was statistically significantly lower than that in the SIMV group (P < 0.050). PaO(2)/FiO(2) ratio in patients in the ASV group in the 3 days was statistically significantly higher than that in the SIMV group (P < 0.050). CONCLUSION: By reducing PIP and improving oxygenation and ABG parameters, ASV mode may be a safe and feasible mode during mechanical ventilation in patients with ARDS. Wolters Kluwer - Medknow 2022-01-29 /pmc/articles/PMC8943583/ /pubmed/35342439 http://dx.doi.org/10.4103/jrms.JRMS_905_18 Text en Copyright: © 2022 Journal of Research in Medical Sciences https://creativecommons.org/licenses/by-nc-sa/4.0/This is an open access journal, and articles are distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 License, which allows others to remix, tweak, and build upon the work non-commercially, as long as appropriate credit is given and the new creations are licensed under the identical terms.
spellingShingle Original Article
Alikiaii, Babak
Abbasi, Saeed
Yari, Hamideh
Akbari, Mojtaba
Kashefi, Parviz
Comparison of adaptive support ventilation and synchronized intermittent mandatory ventilation in patients with acute respiratory distress syndrome: A randomized clinical trial
title Comparison of adaptive support ventilation and synchronized intermittent mandatory ventilation in patients with acute respiratory distress syndrome: A randomized clinical trial
title_full Comparison of adaptive support ventilation and synchronized intermittent mandatory ventilation in patients with acute respiratory distress syndrome: A randomized clinical trial
title_fullStr Comparison of adaptive support ventilation and synchronized intermittent mandatory ventilation in patients with acute respiratory distress syndrome: A randomized clinical trial
title_full_unstemmed Comparison of adaptive support ventilation and synchronized intermittent mandatory ventilation in patients with acute respiratory distress syndrome: A randomized clinical trial
title_short Comparison of adaptive support ventilation and synchronized intermittent mandatory ventilation in patients with acute respiratory distress syndrome: A randomized clinical trial
title_sort comparison of adaptive support ventilation and synchronized intermittent mandatory ventilation in patients with acute respiratory distress syndrome: a randomized clinical trial
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8943583/
https://www.ncbi.nlm.nih.gov/pubmed/35342439
http://dx.doi.org/10.4103/jrms.JRMS_905_18
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