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Variable PSV is a new ventilatory mode which delivered a pressure support "variable" from 0 to 100% variation of the set PSV level.This study aimed to compare the ventilatory behavior, sleep quality and gas exchange between VARIABLE (or Noisy)-PSV and "standard" (or fixed)-PSV during the weaning phase of critically ill patients who required mechanical ventilation.
Twenty patients will be enrolled. They will be ventilated withVARIABLE-PSV and STANDARD-PSV: for 24 h each in a randomized crossover order. The ventilatory parameters, ventilator/patient asynchrony, gas exchange effects, sleep quality and ventilatory comfort produced by the two ventilation modes will be compared. Before randomisation, a sequence of VARIABLE-PSV will be performed with different level of variation setting to better define the future behavior of the patient under this mode during the 24 h of Variable-PSV.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| VARIABLE-PSV ventilatory mode | Other |
| |
| STANDARD-PSV ventilatory mode | Other |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| VARIABLE-PSV ventilatory mode | Other | The two ventilatory modes will be studied during 24h in intubated patients in random order. |
|
| Measure | Description | Time Frame |
|---|---|---|
| Oxygenation in each ventilatory mode | We will performed arterial blood gases and oxygenation wil be evaluated by the PaO2/FiO2 ration. | after 24h of mechanical ventilation in each mode |
| Measure | Description | Time Frame |
|---|---|---|
| Ventilatory comfort | Comfort zone is defined as previously reported in some papers as considered adequate ventilation : 6 < tidal volume < 10 ml/kg, ETCO2 < 55 mmHg and < 65 mmHg for COPD patients and 12 < Respiratory rate < 35 cycles/min. | during 24h in each mode |
| Feasibility |
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Inclusion Criteria:
Exclusion Criteria:
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| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Department of Anesthesiology & Critical Care, St Eloi University Hospital | Montpellier | 34000 | France |
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| ID | Term |
|---|---|
| D016638 | Critical Illness |
| ID | Term |
|---|---|
| D020969 | Disease Attributes |
| D010335 | Pathologic Processes |
| D013568 | Pathological Conditions, Signs and Symptoms |
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| STANDARD-PSV ventilatory mode | Other | The two ventilatory modes will be studied during 24h in intubated patients in random order. |
|
Evaluation of time spent in each mode during the 24 hours of ventilation without any side effects and switch for another ventilatory mode. |
| during the 24 hours |
| Patient/ventilator asynchronism | Evaluation of number of asynchrony evaluated by an Asynchrony Index (AI) in each mode during the 24 hours of mechanical ventilation | during the 24 hours |
| Ventilatory effects | Evaluation of machine ventilatory behaviors in each mode during the 24 hours of mechanical ventilation. | during the 24 hours |
| Sleep quality | Evaluation of quality of sleep in each mode after the 24h of mechanical ventilation | after the 24 hours |