Acute Respiratory Failure Clinical Trial
Official title:
Clinical Evaluation of an Automated Knowledge-based Computer Driven System (SmartCare/PS-NIV) Designed to Automatically Adapt Pressure Support Level and Expiratory Cycling During Non Invasive Ventilation, a Feasability Study.
Knowledge-based systems were initially developped to automatically adapt pressure support
settings during invasive ventilation, and proved to be at least as efficient as experienced
clinicians.
Non-invasive ventilation has become the standard of care for patients suffering from acute
hypercapnic respiratory failure (ARF)and has reduced the need for endotracheal intubation in
these patients, thus reducing their hospital mortality.
NIV success or failure is closely related to the tolerance of NIV treatment, which is
tightly correlated to patient-ventilator synchrony. As severe asynchronies frequently occurs
during NIV (namely in more than 40% of patients) and as the occurence of asynchronies is
related to the use of high pressure support levels, to the presence of leaks and/or to non
optimal expiratory trigger settings, very frequent ventilator settings adaptations should
allow reducing patient-ventilator asynchronies but require the presence of an experienced
clinician at the bedside during NIV treatment.
A computer-driven ventilator settings adaptation has the adavantage of permitting very
frequent ventilator settings adaptation whithout requiring the presence of an experienced
clinician at the bedside and could possibly improve patient-ventilator interaction.
The aim of the present study is to test the faisability of using the Smartcare NIV
computer-driven system to automatically adapt ventilator settings during non invasive
ventilation delivered because of acute respiratory failure.
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