In:
PLOS ONE, Public Library of Science (PLoS), Vol. 18, No. 8 ( 2023-8-23), p. e0289412-
Abstract:
INTELLiVENT–Adaptive Support Ventilation (ASV) is a closed–loop ventilation mode that uses capnography to adjust tidal volume (V T ) and respiratory rate according to a user–set end–tidal CO 2 (etCO 2 ) target range. We compared sidestream versus mainstream capnography with this ventilation mode with respect to the quality of breathing in patients after cardiac surgery. Methods Single–center, single–blinded, non–inferiority, randomized clinical trial in adult patients scheduled for elective cardiac surgery that were expected to receive at least two hours of postoperative ventilation in the ICU. Patients were randomized 1:1 to closed–loop ventilation with sidestream or mainstream capnography. Each breath was classified into a zone based on the measured V T , maximum airway pressure, etCO 2 and pulse oximetry. The primary outcome was the proportion of breaths spent in a predefined ‘optimal’ zone of ventilation during the first three hours of postoperative ventilation, with a non–inferiority margin for the difference in the proportions set at –20%. Secondary endpoints included the proportion of breaths in predefined ‘acceptable’ and ‘critical’ zones of ventilation, and the proportion of breaths with hypoxemia. Results Of 80 randomized subjects, 78 were included in the intention–to–treat analysis. We could not confirm the non–inferiority of closed–loop ventilation using sidestream with respect to the proportion of breaths in the ‘optimal’ zone (mean ratio 0.87 [0.77 to ∞]; P = 0.116 for non–inferiority). The proportion of breaths with hypoxemia was higher in the sidestream capnography group versus the mainstream capnography group. Conclusions We could not confirm that INTELLiVENT–ASV using sidestream capnography is non–inferior to INTELLiVENT–ASV using mainstream capnography with respect to the quality of breathing in subjects receiving postoperative ventilation after cardiac surgery. Trial registration NCT04599491 (clinicaltrials.gov).
Type of Medium:
Online Resource
ISSN:
1932-6203
DOI:
10.1371/journal.pone.0289412
DOI:
10.1371/journal.pone.0289412.g001
DOI:
10.1371/journal.pone.0289412.g002
DOI:
10.1371/journal.pone.0289412.t001
DOI:
10.1371/journal.pone.0289412.t002
DOI:
10.1371/journal.pone.0289412.t003
DOI:
10.1371/journal.pone.0289412.s001
DOI:
10.1371/journal.pone.0289412.s002
DOI:
10.1371/journal.pone.0289412.s003
DOI:
10.1371/journal.pone.0289412.s004
DOI:
10.1371/journal.pone.0289412.s005
DOI:
10.1371/journal.pone.0289412.s006
DOI:
10.1371/journal.pone.0289412.s007
DOI:
10.1371/journal.pone.0289412.s008
DOI:
10.1371/journal.pone.0289412.s009
DOI:
10.1371/journal.pone.0289412.s010
DOI:
10.1371/journal.pone.0289412.s011
DOI:
10.1371/journal.pone.0289412.s012
DOI:
10.1371/journal.pone.0289412.s013
DOI:
10.1371/journal.pone.0289412.s014
Language:
English
Publisher:
Public Library of Science (PLoS)
Publication Date:
2023
detail.hit.zdb_id:
2267670-3
