Variable PSV is a new ventilatory mode which delivered a pressure support "variable" from 0 to 100% variation of the set PSV level.This study aimed to compare the ventilatory behavior, sleep quality and gas exchange between VARIABLE (or Noisy)-PSV and "standard" (or fixed)-PSV during the weaning phase of critically ill patients who required mechanical ventilation.
Twenty patients will be enrolled. They will be ventilated withVARIABLE-PSV and STANDARD-PSV: for 24 h each in a randomized crossover order. The ventilatory parameters, ventilator/patient asynchrony, gas exchange effects, sleep quality and ventilatory comfort produced by the two ventilation modes will be compared. Before randomisation, a sequence of VARIABLE-PSV will be performed with different level of variation setting to better define the future behavior of the patient under this mode during the 24 h of Variable-PSV.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
SINGLE
Enrollment
20
The two ventilatory modes will be studied during 24h in intubated patients in random order.
The two ventilatory modes will be studied during 24h in intubated patients in random order.
Department of Anesthesiology & Critical Care, St Eloi University Hospital
Montpellier, France
Oxygenation in each ventilatory mode
We will performed arterial blood gases and oxygenation wil be evaluated by the PaO2/FiO2 ration.
Time frame: after 24h of mechanical ventilation in each mode
Ventilatory comfort
Comfort zone is defined as previously reported in some papers as considered adequate ventilation : 6 \< tidal volume \< 10 ml/kg, ETCO2 \< 55 mmHg and \< 65 mmHg for COPD patients and 12 \< Respiratory rate \< 35 cycles/min.
Time frame: during 24h in each mode
Feasibility
Evaluation of time spent in each mode during the 24 hours of ventilation without any side effects and switch for another ventilatory mode.
Time frame: during the 24 hours
Patient/ventilator asynchronism
Evaluation of number of asynchrony evaluated by an Asynchrony Index (AI) in each mode during the 24 hours of mechanical ventilation
Time frame: during the 24 hours
Ventilatory effects
Evaluation of machine ventilatory behaviors in each mode during the 24 hours of mechanical ventilation.
Time frame: during the 24 hours
Sleep quality
Evaluation of quality of sleep in each mode after the 24h of mechanical ventilation
Time frame: after the 24 hours
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