Use of the IntelliVent-ASV mode for maintaining the target EtCO2 range in patients with severe TBI

Zhurnal voprosy neĭrokhirurgii imeni N. N. Burdenko
E P Anan'evYa V Savchenko

Abstract

the study purpose was to evaluate the efficacy of the IntelliVent-ASV mode in maintaining the target range of PaCO2 in patients with severe TBI. The study included 12 severe TBI patients with the wakefulness level scored 4-9 (GCS). This was a crossover design study. Two ventilation modes were consecutively used: IntelliVent-ASV and P-CMV, for 12 h each. When using the P-CMV mode, the ventilation parameters were set to maintain PaCO2 in a range of 35-38 mm Hg. The IntelliVent-ASV mode involved the Brain Injury ventilation algorithm. The target range of EtCO2 was set in accordance with the delta PaCO2-EtCO2 to maintain PaCO2 in a range of 35-38. At the beginning of each ventilation period and every 3 hours, the arterial blood gas composition was analyzed. When PaCO2 occurred out of the 35-38 range, appropriate adjustments were made to the ventilation parameters. In the P-CMV mode, the Pinsp and RR parameters were adjusted to achieve the target PaCO2 range. In IntelliVent mode, a shift of the target EtCO2 range was adjusted in accordance with a changed PaCO2-EtCO2 difference. In all patients, ICP, blood pressure, and EtCO2 were monitored; the arterial blood gas composition was analyzed every 3 h; the frequency of manual settings o...Continue Reading

References

May 18, 2012·Critical Care : the Official Journal of the Critical Care Forum·Philippe JouvetMarc Wysocki
Jan 23, 2013·Intensive Care Medicine·François LelloucheMarc Wysocki
Sep 13, 2013·Critical Care : the Official Journal of the Critical Care Forum·Jean-Michel ArnalJacques Durand-Gasselin

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Citations

Aug 3, 2020·British Journal of Anaesthesia·Ashley J R De BieAlexander J G H Bindels

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Brain Injury & Trauma

brain injury after impact to the head is due to both immediate mechanical effects and delayed responses of neural tissues.