PURPOSE: To determine the efficacy of Adaptive support ventilation (ASV) mode in comparison with the standard protocol using T Piece weaning mode among post cardiac surgery patients.
METHODS: Patients were allocated to two parallel Groups, one treated with an ASV-based protocol (group ASV), the other with a standard protocol of respiratory weaning (group control).
RESULTS: Pre weaning and weaning respiratory parameters significant difference was noted on the elevated heart rate Tpiece group, this maybe due to a asynchrony from full mechanical ventilator support in a fully awake patient. In as much as there was a noted decline in the Oxygen saturation of patients in the ASV, this on the other hand maybe attributed to the inadequate minute ventilation in a fully sedated patient thus leading to relative hypoxemia.However in multiple regression analysis with a p- value computed at 0.308, adjusting for the heterogeneity in heart rate, arterial oxygenation (PaO2), and P/F ratio it was found out that there was no significant difference between the two treatment arms. There were also no differences between groups in the duration of weaning , length of tracheal intubation, ICU and hospital stay. Moreover no patient from both arms of the study required reintubation. Nevertheless complications that documented were ventilator associated pneumonia (VAP)and pneumothorax on ASV and TPIECE respectively.
CONCLUSION: In our study it showed that ASV was comparable to Tpiece, since there was no significant difference in the total duration of weaning, total length of intubation, as well as length of ICU and hospital admission between the modes of weaning.
CLINICAL IMPLICATIONS: The advantage of ASV is that it requires less manual manipulation, no additional equipment for weaning and requires less intervention, and repeated assessment, and for these reasons it is likely to be more beneficial in our clinical setting as it would mean to fast and high turnover of patients, less need for highly trained nurses and would require less intensive care beds, as a result it may cause significant overall cost reductions.
DISCLOSURE: Polly Domingo, No Financial Disclosure Information; No Product/Research Disclosure Information