Automated weaning from mechanical ventilation

• 作者: Mirko Belliato
• 来源期刊: 世界呼吸病学杂志
• 学科: 医学
• 关键词: AUTOMATED ventilation AUTOMATED WEANING WEANING from artificial ventilation WEANING PROTOCOL QuickWean
• 年，卷（期）: 2016,（2）
• 页码范围: 49-53
• 页数: 5页
• 分类号: R

摘要

Mechanical ventilation(MV)is one of the lifesaving techniques applied to critically ill patients at bedside.However,some complications,such as ventilator-induced lung injury and ventilator-associated pneumonia,may occur in a patient undertaking MV and are often related to the duration of MV.Some written protocols have been proposed to reduce the risk of such complications,but they can be time consuming,leading to fluctuation in protocol implementation and compliance.Moreover,written instructions tend to be general and thus cannot cover all possible scenarios,resulting in variable interpretation of the protocol.To overcome these limiting factors,protocols have been computerized and there is convincing evidence in the literature showing that computerized protocols benefit management of the process and reduce the time a patient spends under MV.QuickWean is a computeraided weaning protocol implemented on the Hamilton S1 ventilator(Hamilton Medical AG,Bonaduz,Switzerland),which guides the patient through the weaning process without requiring any intervention by the treating physician.The fully-automated ventilation mode is INTELLiVENT?-ASV(Hamilton Medical AG),which is set according to the patient’s respiratory mechanics,patientventilator interaction,peripheral oxygen saturation(SpO2)and pulmonary end-tidal carbon dioxide(PetCO2).The INTELLiVENT?-ASV mode sets automatically each minute to provide accurate ventilation,pressure support,fraction of inspired oxygen and positive end-expiratory pressure based on the patient’s needs.QuickWean can be pre-set to match the established weaning policy of an intensive care unit as well as being customized to a patient’s needs.It provides a progressive reduction of respiratory support,and guides the patient through the spontaneous breathing trial(SBT).At the end of the SBT,the ventilator re-starts the previous ventilation support and provides a report of the successful SBT.During all phases,PetCO2,SpO2 and all breathing parameters are monitored.This new automated weaning too