{Reference Type}: Journal Article
{Title}: Effect of automated versus conventional ventilation on mechanical power of ventilation-A randomized crossover clinical trial.
{Author}: Buiteman-Kruizinga LA;Serpa Neto A;Botta M;List SS;de Boer BH;van Velzen P;Bühler PK;Wendel Garcia PD;Schultz MJ;van der Heiden PLJ;Paulus F; ;
{Journal}: PLoS One
{Volume}: 19
{Issue}: 7
{Year}: 2024
{Factor}: 3.752
{DOI}: 10.1371/journal.pone.0307155
{Abstract}: <B>BACKGROUND: </B>Mechanical power of ventilation, a summary parameter reflecting the energy transferred from the ventilator to the respiratory system, has associations with outcomes. INTELLiVENT-Adaptive Support Ventilation is an automated ventilation mode that changes ventilator settings according to algorithms that target a low work-and force of breathing. The study aims to compare mechanical power between automated ventilation by means of INTELLiVENT-Adaptive Support Ventilation and conventional ventilation in critically ill patients.<BR><B>METHODS: </B>International, multicenter, randomized crossover clinical trial in patients that were expected to need invasive ventilation > 24 hours. Patients were randomly assigned to start with a 3-hour period of automated ventilation or conventional ventilation after which the alternate ventilation mode was selected. The primary outcome was mechanical power in passive and active patients; secondary outcomes included key ventilator settings and ventilatory parameters that affect mechanical power.<BR><B>RESULTS: </B>A total of 96 patients were randomized. Median mechanical power was not different between automated and conventional ventilation (15.8 [11.5-21.0] versus 16.1 [10.9-22.6] J/min; mean difference -0.44 (95%-CI -1.17 to 0.29) J/min; P = 0.24). Subgroup analyses showed that mechanical power was lower with automated ventilation in passive patients, 16.9 [12.5-22.1] versus 19.0 [14.1-25.0] J/min; mean difference -1.76 (95%-CI -2.47 to -10.34J/min; P < 0.01), and not in active patients (14.6 [11.0-20.3] vs 14.1 [10.1-21.3] J/min; mean difference 0.81 (95%-CI -2.13 to 0.49) J/min; P = 0.23).<BR><B>CONCLUSIONS: </B>In this cohort of unselected critically ill invasively ventilated patients, automated ventilation by means of INTELLiVENT-Adaptive Support Ventilation did not reduce mechanical power. A reduction in mechanical power was only seen in passive patients.<BR><B>BACKGROUND: </B>Clinicaltrials.gov (study identifier NCT04827927), April 1, 2021.<BR><B>UNASSIGNED: </B>https://clinicaltrials.gov/study/NCT04827927?term=intellipower&rank=1.