Safety and efficacy of a fully closed-loop control ventilation (IntelliVent-ASV ® ) in sedated ICU patients with acute respiratory failure: a prospective randomized crossover study

Purpose IntelliVent-ASV ® is a development of adaptive support ventilation (ASV) that automatically adjusts ventilation and oxygenation parameters. This study assessed the safety and efficacy of IntelliVent-ASV ® in sedated intensive care unit (ICU) patients with acute respiratory failure. Methods This prospective randomized crossover comparative study was conducted in a 12-bed ICU in a general hospital. Two periods of 2 h of ventilation in randomly applied ASV or IntelliVent-ASV ® were compared in 50 sedated, passively ventilated patients. Tidal volume ( V T ), respiratory rate (RR), inspiratory pressure ( P INSP ), SpO 2 and E T CO 2 were continuously monitored and recorded breath by breath. Mean values over the 2-h period were calculated. Respiratory mechanics, plateau pressure ( P PLAT ) and blood gas exchanges were measured at the end of each period. Results There was no safety issue requiring premature interruption of IntelliVent-ASV ® . Minute ventilation (MV) and V T decreased from 7.6 (6.5–9.5) to 6.8 (6.0–8.0) L/min ( p < 0.001) and from 8.3 (7.8–9.0) to 8.1 (7.7–8.6) mL/kg PBW ( p = 0.003) during IntelliVent-ASV ® as compared to ASV. P PLAT and FiO 2 decreased from 24 (20–29) to 20 (19–25) cmH 2 O ( p = 0.005) and from 40 (30–50) to 30 (30–39) % ( p < 0.001) during IntelliVent-ASV ® as compared to ASV. RR, P INSP , and PEEP decreased as well during IntelliVent-ASV ® as compared to ASV. Respiratory mechanics, pH, PaO 2 and PaO 2 /FiO 2 ratio were not different but PaCO 2 was slightly higher during IntelliVent-ASV ® as compared to ASV. Conclusions In passive patients with acute respiratory failure, IntelliVent-ASV ® was safe and able to ventilate patients with less pressure, volume and FiO 2 while producing the same results in terms of oxygenation.