Source: Annual Congress 2010 - Acute respiratory failure
Disease area: Respiratory critical care

Abstract

Rapid tracheal extubation is a major component of recovery post operatively thus many different strategies have been proposed to reduce the duration of mechanical ventilator after surgery, However specific ventilator strategies aimed in accelerating respiratory weaning after cardiac surgery have received little attention.
Adaptive support ventilation (ASV) is a microprocessor controlled mode of ventilation that maintains an operator preset minimum minute ventilation that is independent of the patient‘s activity. Previous studies have shown that ventilation in ASV enables more rapid weaning .We conducted a randomized control trial to determine whether weaning from ASV results in a shorter time to extubation in comparison with Tpiece weaning after elective cardiac surgery.
Methods: Patients were randomly assigned to ASV or Tpiece weaning after elective cardiac surgery.The primary outcome measured were duration of weaning and failure of extubation. Secondary outcomes measured were duration of mechanical ventilation, associated complications, and length of ICU and hospital stay. Results: Twenty eight patients completed the study. There were also no differences between groups in the duration of weaning, length of tracheal intubation, ICU and hospital stay. Moreover no patient from both arms of the study required reintubation. Complications that documented were ventilator associated pneumonia (VAP) and pneumothorax on ASV and TPIECE respectively
Conclusions: In our study it showed that ASV was comparable to Tpiece, given that there was no significant difference in the total duration of weaning, total length of intubation, and no incidence of reintubation noted in both study arms.

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Citations should be made in the following way:
P. Domingo, T. De Guia, F. Ayuyao, A. Banzon, W. Del Poso (Quezon City, Philippines). Adaptive support ventilation for fast tracheal extubation after elective cardiac surgery. Eur Respir J 2010; 36: Suppl. 54, 2290

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