• Anne Battisti, Didier Tassaux, David Bassin, and Philippe Jolliet.
• Department of Intensive Care, University Hospital, 1211, Geneva 14, Switzerland.
• Intensive Care Med. 2007 Apr 1;33(4):632-8.

ObjectiveTo test the feasibility of applying noninvasive ventilation (NIV) using a prototype algorithm implemented in a bilevel ventilation device designed to adjust pressure support (PS) to maintain a clinician-set alveolar ventilation in patients with acute respiratory failure after initial stabilization.Design And SettingProspective crossover interventional study in an intensive care unit, university hospital.Patients19 patients receiving NIV for acute hypercapnic respiratory failure (13 men, 6 women; mean age 70+/-11 years).MethodsThe same bilevel ventilator was used with manually adjusted PS and with the automated algorithm (autoPS), set to maintain the same alveolar ventilation as in PS. Sequence (measurements at end of each period): (a) prior to initiating NIV (baseline 1); (b) 45 min with manually set PS; (c) 60 min without NIV; (d) 45 min with autoPS; (e) 60 min without NIV; (f) 45 min with manually set PS.ResultsThe magnitude of decrease in PaCO(2) and increase in pH with autoPS was comparable to that of conventional PS, with the same alveolar ventilation and level of PS. No technical problem occurred in autoPS mode, and no NIV trial had to be discontinued because of patient discomfort.ConclusionsThese results suggest that the alveolar ventilation based automatic control of PS during NIV with a bilevel device is feasible and leads to beneficial effects in patients with acute respiratory failure comparable to those of manually set PS. Further studies should now explore the potential of this system over longer periods in patients with acute and chronic respiratory failure.

18 keywords...

hide…