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Controlled cycles in spontaneous-timed noninvasive ventilation: Incidence and associated factors

Published:October 03, 2022DOI:https://doi.org/10.1016/j.rmed.2022.107005

      Highlights

      • Are controlled cycles common during spontaneous timed ventilation, and what do they depend on?
      • Controlled cycles are common in spontaneous-timed ventilation and do not change over the adaptation period. The level of assistance and the patient's own ventilatory pattern are associated with this phenomenon that does not seem to have a deleterious effect.
      • These results should be taken into account when titrating ventilator parameters or selecting a more appropriate ventilation mode.

      Abstract

      Background

      The most-used ventilation mode in home mechanical ventilation (HMV) is spontaneous-timed, designed to be essentially spontaneous with a programmed backup rate.

      Research question

      We do not know the real frequency of activation of controlled cycles, nor its associated factors.

      Study design

      and Methods: We conducted a single-center cohort study of patients with chronic hypoventilation who were started on HMV. We collected the clinical variables, the ventilator programming parameters and the ventilation efficacy data obtained from the built-in software. We analyzed the percentage of controlled cycles (PCC) and the potentially associated clinical variables.

      Results

      Overall, the PCC was very high (median 44%), with little change during the HMV adaptation period. Individuals with a higher PCC (captured patients) had a lower respiratory rate with ventilation, a higher level of ventilatory assistance, and were not associated with a specific clinical profile.

      Interpretation

      Controlled cycles are very common during spontaneous-timed ventilation and depend on the patient's ventilatory pattern and the level of ventilatory assistance.

      Keywords

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