A Prospective Randomized Comparison of INTELLIVENT-ASV and PSV Modes in Terms of Weaning in Intensive Care Patients, Istanbul, Turkiye

Abstract

Background: INTELLIVENT‑Adaptive Support Ventilation (I‑ASV; C6; Hamilton Medical; Bonaduz, Switzerland) is a closed-loop ventilation  mode that continuously controls the patient’s ventilation and oxygenation. It sets the minute ventilation, PEEP, and oxygen levels based  on the targets set by the clinician and on physiological input from the patient. Aim: The aim was to compare I‑ASV and PSV modes  regarding weaning in intensive care patients.

Methods: A total of 140 patients who were over the age of 18 years, did not have a  neuromuscular disease, and had been ventilated for at least 48 hours were reviewed. Using the sequential method, patients who met the  requirements for weaning were put into two groups: I‑ASV and PSV (pressure support ventilation).

Results: The mean age of the I‑ASV  group (n = 70) and the PSV group (n = 70) was 49.11 ± 17.74 and 49.92 ± 22.00, respectively. In the group using I‑ASV, FiO₂ was 30.12 ±  10.04%, inspiratory pressure (Pinsp) was 8.71 ± 2.78 cm H₂O, and Ppeak value was 11.67 ± 2.78 cm H2 O, which were significantly lower  than those in the PSV mode (P < 0.001). The PEEP value was significantly lower in the PSV mode (P < 0.001). However,  asynchrony‑tachycardia was significantly higher in the I‑ASV group (28 (20%)) compared to the PSV group (11 (7.9%)) (P < 0.003).  

Conclusion: I‑ASV mode had no effect on weaning duration compared to PSV mode but decreased PEEP, FiO₂ , Pinsp, and Ppeak values in  weaning patients.