Abstract

BackgroundINTELLiVENT®-ASV (iASV) is a respiration mode on the Hamilton G5. The ventilator uses a closed-loop mechanism that automatically adjusts settings related to oxygenation and ventilation.Case presentationA 47-year-old man underwent reconstruction surgery with free musculocutaneous flap for tongue resection. After surgery, the patient entered the ICU, and the iASV, which automatically changed only the percent minute volume (%MV) in respiration mode, was selected. On the second day, ventilator-associated pneumonia (VAP) was diagnosed, and the antibiotic treatment was changed. Using the settings of the iASV, automated FiO2 and positive end-expiratory pressure (PEEP) control were added to the ventilator mode. The patient’s oxygenation was improved.ConclusionsIn a patient who developed VAP after surgery, ventilation was continued using iASV, and automated changes in PEEP and FiO2 settings were successfully made according to the open lung strategy, under short-staffed circumstances.

Highlights

  • INTELLiVENT®-Adaptive support ventilation (ASV) is a respiration mode on the Hamilton G5

  • If the operator sets the target value of Percutaneous arterial blood oxygen saturation (SpO2) and the End-tidal carbon dioxide concentration (ETCO2), the ventilator automatically adjusts the settings related to oxygenation (FiO2 and positive end-expiratory pressure (PEEP)) and ventilation. iASV is based on adaptive support ventilation (ASV®), which guarantees minute ventilation

  • ASV differs from the conventional mechanical ventilation mode in that the operator sets the target minute ventilation volume, instead of the tidal volume (VT) and respiratory rate (f )

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Summary

Introduction

INTELLiVENT®-ASV (iASV) is a respiration mode on the Hamilton G5. The ventilator uses a closed-loop mechanism that automatically adjusts settings related to oxygenation and ventilation.Case presentation: A 47-year-old man underwent reconstruction surgery with free musculocutaneous flap for tongue resection. It has been reported that iASV can ensure better optimal lung protective ventilation than other conventional ventilation modes and ASV [4]. We describe our experience with a case in which the patient, who was on artificial respiration with deep sedation after surgery, became hypoxic due to ventilator-associated pneumonia (VAP) and for whom ventilator management by iASV was useful.

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