Reinier de Graaf Hospital, Delft, the Netherlands
Amsterdam UMC, location ‘AMC’, Amsterdam, the Netherlands
Sainte Musse Hospital
Team Leader Medical Research
Hamilton Medical AG
Speaker: Laura Buiteman-Kruizinga, Interviewer: Jesse van Akkeren
To kick off this series, we start with the ABC of INTELLiVENT-ASV. What is it and how does it work, what do you see on the screen and how do you adjust settings, why implement it in your ICU and what are the results?
Below you can find the answers to any questions not addressed during the webinar itself.
Speaker: Jean-Michel Arnal, Interviewer: Marco Maggiorini
Patients present with vastly different conditions and their condition may change at any time. In this second webinar, we look at the ways INTELLiVENT-ASV adjusts settings with every breath to maintain the lowest work of breathing and keep parameters within a safe range for each individual patient.
Follow the link below to see the recording.
Speaker: Marcus Schultz, Interviewer: Marco Maggiorini
February 21, 2023; 15:00 / 3:00 pm (CET)
In healthy patients, a lung-protective strategy is often considered unnecessary - especially for short periods of ventilation. But protecting the lung is important in every patient, regardless of their condition. So how can a closed-loop system help when you thought no improvement in ventilation strategy was needed?
Speaker: Giorgio A. Iotti; Interviewer: Marco Maggiorini
March 16, 2023; 15:00 / 3.00 pm (CET)
Severe brain injury couples the need for deep sedation and consequent depression of the respiratory center with the conflicting need for strict control of arterial blood gases. Advanced closed-loop ventilation enables you to provide an artificial respiratory center while still protecting the lung.
Speaker: Laura Buiteman-Kruizinga; Interviewer; Giorgio A. Iotti
April 6, 2023; 15:00 / 3.00 pm (CET)
There has been a lot of talk in recent times about mechanical power. So how does INTELLiVENT-ASV affect this important parameter? And what is the impact on MP of tidal volume and respiratory rate automatically selected by the ASV algorithm? In this webinar we give you an overview of the latest evidence.
Below you can find the answers to those questions not addressed during the webinar and follow the link to access the webinar's recording.
This depends on the patient's disease and lung condition, but for example in ARDS patients it is common to target a somewhat lower SpO2 of 90-94% to prevent excessive oxygen use and thus help prevent VILI. This usually results in a lower level of oxygen.
We used and still use APV-CMV (adaptive pressure ventilation), pressure controlled ventilation, pressure support ventilation and ASV.
When there is a measurement failure for any reason, INTELLiVENT-ASV will stop adjusting and freeze settings, and will generate alarms. If there is no solution at that time, i.e., SpO2 measurement due to poor perfusion, you can choose to set the controller to 'manual'.
The set I:E ratio by INTELLiVENT‑ASV is based on the RCexp, also known as the time constant. Meaning that there is a measurement of the duration of expiration based on lung mechanics and the expiration time will adjust to that. For example, for a lung with high compliance like COPD, INTELLiVENT‑ASV will set a longer expiration time and therefore prevent for auto‑PEEP.
Indeed, you try to ensure the best measurement with different options, and if the quality of the measurement is poor due to the illness of the patient, you can choose to set the controller to 'manual' until measurements are improved, then you can turn back to 'automatic'.
This is a matter of setting PEEP limits well or if necessary you can always set PEEP to 'manual'. Then you still have the advantage of automated adjustments of FiO2 and automated setting and adjustments of the VT/RR combination.
We have used it in these patients, but comparable to conventional ventilation you still need to check tidal volumes, pressures and adjust where necessary.
I think this is comparable to conventional ventilation, where you also check the pCO2 in the arterial blood gas and adjust settings where necessary.
In my experience, there are no unwanted pressure drops in spontaneously breathing patients.
Regarding implementation, this could be a webinar of its own :). Our team is focused on innovation and there are good arguments for using INTELLiVENT-ASV.
Well, as explained in the webinar, as a user you are still in control and are supervising the ventilator and adjusting targets, limits and settings, if necessary with measurements like Vd/Vt and pH.
There is, in my opinion, not a specific difference between these patient groups, good results achieved in both groups.
No, this is the responsibility of the caregiver, because you are still in control of settings, limits and additional measurements for setting ventilation parameters.
The logic behind selecting a specific breathing pattern (Vt and RR) is based on lung mechanics, and it’s clearly described in literature. The algorithms used by INTELLiVENT-ASV for CO2 elimination and oxygenation are based on patient signals and user-set targets and limits. The way INTELLiVENT-ASV sets the parameters based on lung mechanics and "how and why" is available in the ventilator's operator’s manual, as well as in the clinical literature.
Follow the link below to watch the recording. Answers to those questions not addressed during the webinar are coming soon!
The contents of this page are for informational purposes only and are not intended to be a substitute for professional training or for standard treatment guidelines in your facility. The responses to the questions on this page were prepared by the respective webinar's speaker; any recommendations made here with respect to clinical practice or the use of specific products, technology, or therapies represent the personal opinion of the speaker only, and may not be considered as official recommendations made by Hamilton Medical AG. Hamilton Medical AG provides no warranty with respect to the information contained ion this page and reliance on any part of this information is solely at your own risk.