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.
Eur Respir J. 2011 Oct;38(4):774-80. doi: 10.1183/09031936.00081510. Epub 2011 Mar 15.
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.
适应性支持通气（ASV）是一种闭环通气模式，可同时作为压力支持通气（PSV）和压力控制通气。使用 ASV 进行撤机显示出有前景的结果，主要是在心脏手术后的患者中。本随机对照研究的目的是检验以下假设，即在慢性阻塞性肺疾病（COPD）患者中，与 PSV 相比，使用 ASV 进行撤机可以缩短撤机时间。在 20 个月的时间里，共有 435 名 COPD 患者入住重症监护病房（ICU），其中 97 名患者被纳入研究。患者被随机分配到 ASV 或 PSV 作为撤机模式。与 PSV 相比，ASV 提供了更短的撤机时间（中位数 24（四分位距 20-62）小时与 72（24-144）小时，p=0.041），撤机成功率相似（ASV 组 49 例中有 35 例，PSV 组 48 例中有 33 例）。使用 ASV 时 ICU 的住院时间也较短，但差异无统计学意义。本研究表明，ASV 可用于 COPD 患者的撤机，具有缩短撤机时间的优势。需要进一步研究来探讨 ASV 在不同患者群体撤机期间的作用和潜在优势。
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