Closed loop ventilation mode in Intensive Care Unit: a randomized controlled clinical trial comparing the numbers of manual ventilator setting changes.

Background: There is an equipoise regarding closed-loop ventilation modes and the ability to reduce workload for providers. On one hand some settings are managed by the ventilator but on another hand the automatic mode introduces new settings for the user.

Methods: This randomized controlled trial compared the number of manual ventilator setting changes between a full closed loop ventilation and oxygenation mode (INTELLiVENT-ASV®) and conventional ventilation modes (volume assist control and pressure support) in Intensive Care Unit (ICU) patients.

Dynamics of end expiratory lung volume after changing positive end-expiratory pressure in acute respiratory distress syndrome patients.

Introduction: Lung recruitment maneuvers followed by an individually titrated positive end-expiratory pressure (PEEP) are the key components of the open lung ventilation strategy in acute respiratory distress syndrome (ARDS). The staircase recruitment maneuver is a step-by-step increase in PEEP followed by a decremental PEEP trial. The duration of each step is usually 2 minutes without physiologic rationale.

Efficiency and safety of a noninvasive therapeutic hypothermia protocol in cardiac arrest.

Objectives: Therapeutic hypothermia (TH) is part of the treatment strategy for comatose survivors of cardiac arrest (CA). The aim of our study was to evaluate the efficiency and the safety of a noninvasive and affordable cooling procedure applied to all types of CA in an ICU.

Study Design: This was a retrospective, observational, monocenter study.

Feasibility study on full closed-loop control ventilation (IntelliVent-ASV™) in ICU patients with acute respiratory failure: a prospective observational comparative study.

Introduction: IntelliVent-ASV™ is a full closed-loop ventilation mode that automatically adjusts ventilation and oxygenation parameters in both passive and active patients. This feasibility study compared oxygenation and ventilation settings automatically selected by IntelliVent-ASV™ among three predefined lung conditions (normal lung, acute respiratory distress syndrome (ARDS) and chronic obstructive pulmonary disease (COPD)) in active and passive patients. The feasibility of IntelliVent-ASV™ use was assessed based on the number of safety events, the need to switch to conventional mode for any medical reason, and sensor failure.

Safety and efficacy of a fully closed-loop control ventilation (IntelliVent-ASV®) in sedated ICU patients with acute respiratory failure: a prospective randomized crossover study.

Purpose: IntelliVent-ASV(®) is a development of adaptive support ventilation (ASV) that automatically adjusts ventilation and oxygenation parameters. This study assessed the safety and efficacy of IntelliVent-ASV(®) in sedated intensive care unit (ICU) patients with acute respiratory failure.

Methods: This prospective randomized crossover comparative study was conducted in a 12-bed ICU in a general hospital.

Optimal duration of a sustained inflation recruitment maneuver in ARDS patients.

Purpose: To measure the dynamics of recruitment and the hemodynamic status during a sustained inflation recruitment maneuver (RM) in order to determine the optimal duration of RM in acute respiratory distress syndrome (ARDS) patients.

Methods: This prospective study was conducted in a 12-bed intensive care unit (ICU) in a general hospital. A 40 cmH(2)O sustained inflation RM maintained for 30 s was performed in 50 sedated ventilated patients within the first 24 h of meeting ARDS criteria.

Recruitability of the lung estimated by the pressure volume curve hysteresis in ARDS patients.

Objective: To assess the hysteresis of the pressure-volume curve (PV curve) as to estimate, easily and at the bedside, the recruitability of the lung in ARDS patients.

Design: Prospective study.

Setting: Twelve medico-surgical ICU beds of a general hospital.

Automatic selection of breathing pattern using adaptive support ventilation.

Objective: In a cohort of mechanically ventilated patients to compare the automatic tidal volume (VT)-respiratory rate (RR) combination generated by adaptive support ventilation (ASV) for various lung conditions.

Design And Setting: Prospective observational cohort study in the 11-bed medicosurgical ICU of a general hospital.

Patients: 243 patients receiving 1327 days of invasive ventilation on ASV.

A risk score-dependent antiemetic approach effectively reduces postoperative nausea and vomiting--a continuous quality improvement initiative.

Purpose: In a previous survey, patients at risk for postoperative nausea and vomiting (PONV) were best identified by a simplified risk score. Consequently, we investigated whether a risk score-dependent antiemetic strategy could effectively reduce the incidence of PONV in our department.

Methods: Adult in-patients (n = 428) scheduled for throat, thyroid, breast or gynecological surgery under general anesthesia were prospectively classified in three risk groups (L = low, M = medium, H = high) by using a simplified risk score.