Advanced closed loops during mechanical ventilation (PAV, NAVA, ASV, SmartCare)
Advanced closed loops during mechanical ventilation (PAV, NAVA, ASV, SmartCare)
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DOI：
10.1016/j.bpa.2008.08.001
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发表时间：
2009-03-01
影响因子：
4.8
通讯作者：
Brochard, Laurent
中科院分区：
文献类型：
--
作者：
Lellouche, Francois;Brochard, Laurent
具有先进闭环的新型机械通气模式现已可用，并且在未来，由于多种原因，这些模式可能在支持重症监护病房（icu）危重患者方面发挥更大的作用。两种通气模式-比例辅助通气和神经调节通气辅助-提供与患者努力成比例的辅助通气，改善患者-呼吸机同步。此外，一些具有先进闭环的医学推理自动化系统，如SmartCare和自适应支持通风，有可能通过不断实施自动化协议来改善知识转移。此外，它们可以改善患者与呼吸机的相互作用和结果，并通过减少重症监护病房相关费用、机械通气时间和工作人员工作量，为预测的临床医生短缺提供部分解决方案。初步研究是有希望的，随着临床经验的增加，初始系统目前正在完善。随着这些系统的出现，机械通风的新时代应该会出现。(C) 2008 Elsevier Ltd版权所有。
New modes of mechanical ventilation with advanced closed loops are now available, and in the future these could assume a greater role in supporting critically ill patients in intensive care units (ICUs) for several reasons. Two modes of ventilation - proportional assist ventilation and neurally adjusted ventilatory assist - deliver assisted ventilation proportional to the patient's effort, improving patient-ventilator synchrony. Also, a few systems that automate the medical reasoning with advanced closed-loops, such as SmartCare and adaptive support ventilation, have the potential to improve knowledge transfer by continuously implementing automated protocols. Moreover, they may improve patient-ventilator interactions and outcomes, and provide a partial solution to the forecast clinician shortages by reducing ICU-related costs, time spent on mechanical ventilation, and staff workload. Preliminary studies are promising, and initial systems are currently being refined with increasing clinical experience. A new era of mechanical ventilation should emerge with these systems. (C) 2008 Elsevier Ltd. All rights reserved.