Treatment of critically ill patients with acute hypercarbic respiratory failure by average volume-assured pressure support mode

被引:3
作者
Akbas, Turkay [1 ]
Altun, Gulsah [2 ]
机构
[1] Duzce Univ, Div Intens Care, Dept Internal Med, Fac Med, Duzce, Turkey
[2] Duzce Univ, Dept Internal Med, Fac Med, Duzce, Turkey
关键词
chronic obstructive pulmonary disease; hypercarbic respiratory failure; mortality; noninvasive mechanic ventilation; volume guaranteed ventilation; OBSTRUCTIVE PULMONARY-DISEASE; INTENSIVE-CARE-UNIT; NONINVASIVE VENTILATION; OBESITY; EXACERBATIONS; ADJUSTMENT; COPD;
D O I
10.1111/crj.13401
中图分类号
R56 [呼吸系及胸部疾病];
学科分类号
摘要
Objectives Average volume-assured pressure support (AVAPS), a dual mode, delivers a set tidal volume (TV) per kg by adjusting the pressure between upper and lower inspiratory positive airway pressures (IPAP). Thus, ventilation is presumed to be happened effectively by sending a guaranteed TV. This study was aimed to evaluate the effectiveness of AVAPS mode in critically ill patients with acute hypercarbic respiratory failure (HRF) and compare the results with bilevel positive airway pressure-spontaneous/timed (BPAP-S/T) mode. Methods Sixty patients were assigned to BPAP-S/T (n = 29) and AVAPS modes (n = 31). Maximum IPAP was started at 20 cmH(2)O and minimum IPAP was set at 5 cmH(2)O higher than expiratory positive airway pressure (EPAP) in AVAPS mode. IPAP was started at 15 cmH(2)O in BPAP-S/T mode. IPAP levels were titrated up to 30 cmH(2)O during noninvasive mechanic ventilation (NIMV) with a targeted TV of 6-8 mL/kg. Patients were followed for 5 days. Results No differences were found in pH, paCO(2), HCO3, TV and EPAP between the two groups when compared separately by days. Maximum IPAP levels were significantly high in AVAPS mode in all times (P < 0.001). The length of stay (LOS) in intensive care unit (ICU) (P = 0.994) and hospital (P = 0.509), hours of NIMV use per day (P = 0.101) and NIMV success rate (P = 0.931) were identical between the two groups. ICU (P = 0.931), hospital (P = 0.800), 6-month (P = 0.919) and 1-year (P = 0.645) mortality rates were also not different between the both groups. Conclusions AVAPS mode had similar efficiency with BPAP-S/T mode regarding the NIMV treatment success in critically ill patients with acute HRF.
引用
收藏
页码:973 / 982
页数:10
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