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Automatic Tube Compensation Versus Pressure Support Ventilation as a Weaning Mode, Does It Make a Difference? FREE TO VIEW

Safaa Wafy, MD; Hamad El-Shahat, MD; Suzan Salama, MD; Hassan Bayoumi, MS
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Assiut University, Assiut, Egypt

Chest. 2015;148(4_MeetingAbstracts):312A. doi:10.1378/chest.2250779
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SESSION TITLE: Mechanical Ventilation and Respiratory Failure Posters

SESSION TYPE: Original Investigation Poster

PRESENTED ON: Wednesday, October 28, 2015 at 01:30 PM - 02:30 PM

PURPOSE: Background Automatic tube compensation (ATC) is one of newer weaning modes that seem promising to improve weaning process. Objective To evaluate the benefit of ATC in hastening and improving weaning process.

METHODS: In a prospective randomized controlled trial, all eligible patients of Assiut Chest Department who were mechanically ventilated were included for two years duration.They were divided into two groups, 88 patients weaned by pressure support ventilation (PSV) and 78 patients weaned by automatic tube compensation (ATC). The primary outcomes measure was the ability to maintain spontaneous breathing for more than 48 hours after extubation and weaning duration.

RESULTS: 166 patients were included; the mean age was 58.6 ±12.3 years; males represented 70%. The weaning duration was shorter in ATC than PSV (19.7 versus 29.9 hours respectively). Also, ATC had higher trend toward successful extubation than PSV (88.5% versus 78.4%). Patients underwent weaning by ATC had non-significant trend toward simple weaning. Moreover, hospital mortality was less in ATC (ATC 15.4% versus PSV 22.7%). However, the difference did not reach significant difference in all primary and secondary outcomes.

CONCLUSIONS: In a respiratory ICU patients, weaning process can be usefully performed by ATC (at least as effective as PSV) but, without significant hastening the weaning process. All primary and secondary outcomes were potentially improved (weaning duration, extubation outcome, predictive value of ATC-assisted RR/TV, number of SBTs, weaning category, reintubation rate, complications and hospital mortality).

CLINICAL IMPLICATIONS: In a respiratory ICU population, Automatic tube compensation was safe, reliable and can be reasonably used for weaning trials. ATC confers a potential benefit in weaning duration, weaning category, number of spontaneous breathing trial, failure of first SBT extubation outcome, ICU length of stay, complication and mortality rate. In addition, ATC improve the predictive value of RR/TV and IWI in predicting weaning success. When evaluating all these variables collectively, we can state that ATC might improve weaning process.

DISCLOSURE: The following authors have nothing to disclose: Safaa Wafy, Hamad El-Shahat, Suzan Salama, Hassan Bayoumi

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