Comparison of Two Ventilator Mode During the Night: New Strategy of Mechanical Ventilation Weaning

Pressure Controlled Ventilation Versus Pressure Support Ventilation During the Night: New Strategy of Mechanical Ventilation Weaning?

The purpose of the study is to compare pressure controlled continuous mandatory ventilation versus pressure support ventilation during the night for weaning to mechanical ventilation in chronic obstructive pulmonary disease patients and their impact onto sleep quality.

Inclusion Criteria:

• The patient and/or legal representative of the patient has provided a written informed consent before inclusion in the study
• The patients is hospitalized in respiratory and critical care unit (university hospital of AMIENS, FRANCE)
• the patient is mechanically ventilated (ventilator model : puritan-bennett B840)
• Pulmonary disease,chronic obstructive (Spirometry and Blood Gas Analysis in chronic state before admission)
• stable cardiovascular status (cardiac frequency < 140 beats/min and systolic blood pressure : 90-160 mmHg without catecholamines)
• midazolam < 0,05mg/kg/h
• sufentanyl < 0,05µ/kg/h
• the disorder that caused respiratory failure and prompted mechanical ventilation is treated
• the clinician suspects the patient may be ready to begin the weaning process
• inspiratory oxygen fraction (FiO2) < 50%
• positive end-expiratory pressure < or equal 8cmH2O
• during the day, the patient tolerate pressure support ventilation (pressure support level < 15cmH2O
• respiratory frequency (FR) < 35 breaths/min
• tidal volume (VT) > 5ml/kg
• PaO2/FiO2 > 200 mmHg
• FR/VT < 105 breaths/min/L

Exclusion Criteria:

• sleep apnea, central
• narcolepsy
• Encephalopathy, Metabolic AND Encephalitis