title: Adaptive support ventilation for faster weaning in COPD: a randomised controlled trial.
abstract: Adaptive support ventilation (ASV) is a closed-loop ventilation mode that can act both as pressure support ventilation (PSV) and pressure-controlled ventilation. Weaning with ASV shows promising results, mainly in post-cardiac surgery patients. The aim of the present randomised controlled study was to test the hypothesis that weaning with ASV could reduce the weaning duration in patients with chronic obstructive pulmonary disease (COPD) when compared with PSV. From among 435 COPD patients admitted to the intensive care unit (ICU) during a 20-month period, 97 were enrolled. Patients were assigned at random to either ASV or PSV as a weaning mode. Compared with PSV, ASV provided shorter weaning times (median 24 (interquartile range 20-62) h versus 72 (24-144) h, p=0.041) with similar weaning success rates (35 out of 49 for ASV and 33 out of 48 for PSV). Length of stay in the ICU was also shorter with ASV but the difference was not statistically significant. This study suggests that ASV may be used in the weaning of COPD patients with the advantage of shorter weaning times. Further studies are needed to investigate the role and potential advantages of ASV in the weaning period of different patient groups.
authors.affiliation: Intensive Care Unit, Izmir Dr Suat Seren Chest Diseases and Thoracic Surgery Education and Research Hospital, 1671 sok. No, 159 D, 5 35530 Karsiyaka Izmir, Turkey. ckirakli@hotmail.com
authors.forename: C
authors.initials: C
authors.lastname: Kirakli
authors.forename: I
authors.initials: I
authors.lastname: Ozdemir
authors.forename: Z Z
authors.initials: ZZ
authors.lastname: Ucar
authors.forename: P
authors.initials: P
authors.lastname: Cimen
authors.forename: S
authors.initials: S
authors.lastname: Kepil
authors.forename: S A
authors.initials: SA
authors.lastname: Ozkan
mesh_terms: D018806:APACHE; D000208:Acute Disease; D000368:Aged; D060666:Airway Extubation / Q000592:standards; D005260:Female; D006801:Humans; D007362:Intensive Care Units / Q000592:standards*; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D011175:Positive-Pressure Respiration / Q000379:methods* / Q000592:standards; D029424:Pulmonary Disease, Chronic Obstructive / Q000150:complications / Q000628:therapy*; D012131:Respiratory Insufficiency / Q000209:etiology / Q000628:therapy*; D013997:Time Factors; D014139:Tracheostomy / Q000592:standards; D015300:Ventilator Weaning / Q000379:methods* / Q000592:standards