Assist-control ventilation vs. low levels of pressure support ventilation on sleep quality in intubated ICU patients.
OBJECTIVE
To compare the impact of assist-control ventilation (ACV) and pressure support ventilation with 6 cmH2O inspiratory pressure (low PSV) on sleep quality.


METHODS
Prospective randomized cross-over study.


METHODS
Twenty intubated and mechanically ventilated patients for acute on chronic respiratory failure.


METHODS
Patients were monitored by standard polysomnography at the end of their weaning period. Patients were assigned to receive either ACV from 10 p.m. to 2 a.m. and low PSV from 2 a.m. to 6 a.m. (ACV/low PSV group) or low PSV from 10 p.m. to 2 a.m. and ACV from 2 a.m. to 6 a.m. (low PSV/ACV group).


RESULTS
There were significant increases in stages 1 and 2 non-rapid eye movement (NREM) sleep and reduction in wakefulness during the first part of the night and significant increases in stages 3 and 4 NREM sleep during the second part of the night were observed with ACV compared to low PSV. A significant negative correlation was observed between the perceived sleep quality and the amount of wakefulness while the amount of stage 2 NREM sleep was positively correlated with perceived sleep quality.


CONCLUSIONS
ACV was significantly associated with a better sleep quality than those recorded during pressure support. The perception of sleep quality appeared to be better with ACV than with low PSV. On the basis of these results we recommend that intubated and mechanically ventilated patients for acute on chronic respiratory failure should be reventilated at night during their weaning period.
Toublanc
Bénédicte
B
Department of Respiratory Medicine, Centre Hospitalier Universitaire Sud, Avenue René Laënnec, 80054, Amiens Cedex 1, France.
Rose
Dominique
D
EEG Unit, Centre Hospitalier Universitaire Sud, 80054, Amiens Cedex 1, France.
Glérant
Jean-Charles
JC
Department of Respiratory Medicine, Centre Hospitalier Universitaire Sud, Avenue René Laënnec, 80054, Amiens Cedex 1, France.
Francois
Géraldine
G
Department of Respiratory Medicine, Centre Hospitalier Universitaire Sud, Avenue René Laënnec, 80054, Amiens Cedex 1, France.
Mayeux
Isabelle
I
Department of Respiratory Medicine, Centre Hospitalier Universitaire Sud, Avenue René Laënnec, 80054, Amiens Cedex 1, France.
Rodenstein
Daniel
D
Department of Respiratory Medicine, Cliniques Universitaires Saint Luc, Université Catholique de Louvain, 1200, Brussels, Belgium.
Jounieaux
Vincent
V
Department of Respiratory Medicine, Centre Hospitalier Universitaire Sud, Avenue René Laënnec, 80054, Amiens Cedex 1, France. jounieaux.vincent@chu-amiens.fr.
D000368:Aged; D000369:Aged, 80 and over; D018592:Cross-Over Studies; D005260:Female; D006801:Humans; D007362:Intensive Care Units; D007442:Intubation, Intratracheal; D008297:Male; D008875:Middle Aged; D017286:Polysomnography; D011446:Prospective Studies; D012121:Respiration, Artificial / Q000379:methods*; D012131:Respiratory Insufficiency / Q000628:therapy; D012890:Sleep / Q000502:physiology*; D013995:Time; D014851:Wakefulness / Q000502:physiology