Proportional Assisted Ventilation and Pressure Support Ventilation in Adult Patients With Prolonged Ventilation

Kaohsiung Veterans General Hospital.44 enrolled

Overview

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.

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.

Study Type

INTERVENTIONAL

Allocation

RANDOMIZED

Purpose

TREATMENT

Masking

NONE

Enrollment

Conditions

Respiratory Failure Respiration, Artificial

Interventions

PAV+ modeDEVICE

PAV+ mode by using Puritan-Bennett 840 ventilator

PSV modeDEVICE

PSV mode by using Puritan-Bennett 840 ventilator

Eligibility

Sex: ALLMin age: 20 Years

Medical Language ↔ Plain English

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.

Locations (1)

Kaohsiung Veterans General Hospital

Kaohsiung City, Taiwan

Outcomes

Primary Outcomes

28-day weaning success rate

Weaning success was defined as being alive and liberation from MV for more than 48 hours.

Time frame: 28 days

Secondary Outcomes

Weaning duration

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).

Time frame: up to 28 days

Hospital length of stay

Patients were followed to discharge to calculate the length of hospitalization

Time frame: up to 123 days

Weaning success at discharge

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

Time frame: up to 123 days

Hospital mortality

Patients were followed to discharge to calculate the mortality rate during hospitalization.

Time frame: up to 123 days

Data from ClinicalTrials.gov

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