Adaptive Support Ventilation for Faster Weaning in COPD: A Randomized Controlled Trial

Objective: Adaptive support ventilation (ASV) is a closed loop ventilation mode that can act both as pressure support (PSV) and pressure controlled (PCV) ventilation. Weaning with ASV shows promising results mainly in post-cardiac surgery patients. The aim of this randomized controlled study was to test the hypothesis that weaning with ASV could reduce the weaning duration in patients with chronic obstructive pulmonary disease (COPD) when compared with PSV. Patients and Methods: From among 435 COPD patients admitted in the ICU during a 20-month period, 97 were enrolled. Patients were assigned at random to either ASV or PSV as a weaning mode. Measurements and Main Results: Compared with PSV, ASV provided shorter weaning times (median [IQR]: 24 hours [20-62] vs. 72 hours [24-144], p=0,041) with similar weaning success rates (34/49 for ASV and 32/48 for PSV). Length of stay in the ICU also seemed shorter with ASV but the difference was not statistically significant. Conclusions: This study suggests that ASV may be used in the weaning of COPD patients with the advantage of shorter weaning times. Further studies are needed to investigate the role and potential advantages of ASV in the weaning period of different patient groups.