Comparative analysis of fully automated vs. conventional ventilation in postoperative cardiac surgery patients: Impact on alarms, interventions, and nurse acceptance

Abstract

Objectives: To compare the number of alarms, interventions and nurses’ acceptance of automated ventilation with INTELLiVENT-ASV versus conventional ventilation strategy in patients receiving postoperative ventilation after cardiac surgery. Methods: This preplanned secondary analysis of the ‘POSITiVE’ randomized clinical trial compared INTELLiVENT-ASV (automated ventilation) with conventional ventilation in postoperative cardiac surgery patients. The number of critical alarms and manual ventilator interventions were compared during the first three hours of ventilation or until extubation. Nurses’ acceptance was assessed using a Technology Acceptance Model 2-based questionnaire and a user acceptance score from 1 to 10. Results: POSITiVE randomized 220 patients (109 to automated and 111 to conventional ventilation). The average number of critical alarms per monitoring hour was similar between the automated and conventional group (5.6 vs 5.7; p = 0.823). The automated group required fewer manual interventions per monitoring hour for both ventilation control (0.7 vs 1.9; p < 0.001) and alarm management (2.0 vs 2.8; p < 0.001). The automated ventilation mode scored higher for perceived usefulness (2.6 vs 2.1; p < 0.001) and user acceptance (8.0 vs 7.0; p < 0.001), but similar for perceived ease of use. Conclusions: Automated ventilation for postoperative cardiac surgery patients had similar alarm frequencies as conventional ventilation, but reduced the number of interventions and showed higher nurses’ acceptance, indicating its potential to optimize patient care and reduce nurses’ workload. Implications for Clinical Practice: Our findings suggest that automated ventilation modes like INTELLiVENT-ASV can reduce the frequency of manual interventions and improve nurses’ acceptance, which may help alleviate nurses’ workload for postoperative cardiac surgery patients.