Respiratory Failure, Respiration, Artificial
Conditions
Keywords
Proportional assist ventilation, Pressure support ventilation, Weaning, Prolonged mechanical ventilation
Brief summary
A prospective randomized controlled trial was conducted to collect patients with prolonged mechanical ventilation. Patients were randomly assigned to receive PAV+ or PSV as weaning mode. Weaning outcomes were compared between 2 groups.
Detailed description
Pressure support ventilation (PSV) the most frequently used mode of ventilator support in intensive care units, but has several demerits. Proportional assist ventilation with load-adjustable gain factors (PAV+) is a promising mode with better patient synchrony and weaning advantages. However, weaning outcome of PAV+ in patients with prolonged mechanical ventilation has not been evaluated before. We conducted a prospective randomized controlled trial in a tertiary medical center. This study aimed to compare the effectiveness between PAV+ and PSV for weaning adult patients with prolonged mechanical ventilation.
Interventions
DEVICEPAV+ mode
PAV+ mode by using Puritan-Bennett 840 ventilator
DEVICEPSV mode
PSV mode by using Puritan-Bennett 840 ventilator
Sponsors
Kaohsiung Veterans General Hospital.
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
NONE
Eligibility
Sex/Gender
ALL
Age
20 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* Patients with prolonged mechanical ventilation and transfer to respiratory care center, age of 20 years or older, at least 1 time of extubation failure or spontaneous breathing trial failure in ICU, stable hemodynamics, no vasopressor use, FiO2 = 0.40 or less, external positive end-expiratory pressure = 5 cmH2O or less, PaO2 \> 60 mmHg, and body temperature \< 38ºC (within 24 hours).
Exclusion criteria
* Patients with bronchopleural fistulas, central neurological disorders, hemodialysis, and those with pressure support level already \< 15 cmH2O.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| 28-day weaning success rate | 28 days | Weaning success was defined as being alive and liberation from MV for more than 48 hours. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Weaning duration | up to 28 days | Weaning duration was defined as the time from randomization to successful liberation from MV. For those who failed to liberate from MV throughout the course of weaning trial, the weaning duration was defined from randomization to the end of study (up to 28 days). |
| Hospital length of stay | up to 123 days | Patients were followed to discharge to calculate the length of hospitalization |
| Weaning success at discharge | up to 123 days | Patients were followed to discharge to calculate weaning success rate at discharge, which is defined as status of being alive and successful weaned at patient discharge |
| Hospital mortality | up to 123 days | Patients were followed to discharge to calculate the mortality rate during hospitalization. |
Countries
Taiwan
Outcome results
None listed