Effects of closed loop ventilation on ventilator settings, patient outcomes and ICU staff workloads - A systematic review
Issued Date
2024-06-01
Resource Type
ISSN
02650215
eISSN
13652346
Scopus ID
2-s2.0-85192028132
Pubmed ID
38385449
Journal Title
European Journal of Anaesthesiology
Volume
41
Issue
6
Start Page
438
End Page
446
Rights Holder(s)
SCOPUS
Bibliographic Citation
European Journal of Anaesthesiology Vol.41 No.6 (2024) , 438-446
Suggested Citation
Goossen R.L., Schultz M.J., Tschernko E., Chew M.S., Robba C., Paulus F., Van Der Heiden P.L.J., Buiteman-Kruizinga L.A. Effects of closed loop ventilation on ventilator settings, patient outcomes and ICU staff workloads - A systematic review. European Journal of Anaesthesiology Vol.41 No.6 (2024) , 438-446. 446. doi:10.1097/EJA.0000000000001972 Retrieved from: https://repository.li.mahidol.ac.th/handle/20.500.14594/98344
Title
Effects of closed loop ventilation on ventilator settings, patient outcomes and ICU staff workloads - A systematic review
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Abstract
BACKGROUNDLung protective ventilation is considered standard of care in the intensive care unit. However, modifying the ventilator settings can be challenging and is time consuming. Closed loop modes of ventilation are increasingly attractive for use in critically ill patients. With closed loop ventilation, settings that are typically managed by the ICU professionals are under control of the ventilator's algorithms.OBJECTIVESTo describe the effectiveness, safety, efficacy and workload with currently available closed loop ventilation modes.DESIGNSystematic review of randomised clinical trials.DATA SOURCESA comprehensive systematic search in PubMed, Embase and the Cochrane Central register of Controlled Trials search was performed in January 2023.ELIGIBILITY CRITERIARandomised clinical trials that compared closed loop ventilation with conventional ventilation modes and reported on effectiveness, safety, efficacy or workload.RESULTSThe search identified 51 studies that met the inclusion criteria. Closed loop ventilation, when compared with conventional ventilation, demonstrates enhanced management of crucial ventilator variables and parameters essential for lung protection across diverse patient cohorts. Adverse events were seldom reported. Several studies indicate potential improvements in patient outcomes with closed loop ventilation; however, it is worth noting that these studies might have been underpowered to conclusively demonstrate such benefits. Closed loop ventilation resulted in a reduction of various aspects associated with the workload of ICU professionals but there have been no studies that studied workload in sufficient detail.CONCLUSIONSClosed loop ventilation modes are at least as effective in choosing correct ventilator settings as ventilation performed by ICU professionals and have the potential to reduce the workload related to ventilation. Nevertheless, there is a lack of sufficient research to comprehensively assess the overall impact of these modes on patient outcomes, and on the workload of ICU staff.