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ORIGINAL ARTICLE
Year : 2017  |  Volume : 15  |  Issue : 3  |  Page : 142-147

Value of automatic tube compensation in weaning of mechanically ventilated patients in medical ICU


1 Department of Internal Medicine, Al-Azhar University, Cairo, Egypt
2 Department of Chest Diseases, Al-Azhar University, Cairo, Egypt

Correspondence Address:
Ahmed E Kabil
Department of Chest Diseases, Al-Azhar University, Cairo
Egypt
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/AZMJ.AZMJ_29_17

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Background Automatic tube compensation (ATC) has been recently introduced to compensate for artificial airway resistance that may be beneficial during spontaneous breathing trials. It has been used as a mode of mechanical ventilation in some newer mechanical ventilators and as an add-on feature for the existing ventilation modes in some other ventilators. Objective To assess the expected value of ATC in the weaning process. Patients and methods A prospective randomized controlled study was conducted at the Medical ICU of Al-Hussein University Hospital, Cairo. Sixty mechanically ventilated patients were included during the period from September 2016 to June 2017. The patients were randomly divided into three groups: 20 patients were weaned by pressure support ventilation (PSV) plus ATC, 20 patients were weaned by PSV alone and 20 patients were weaned by ATC alone. The primary outcome measure was comparison between different groups in weaning outcomes and duration of weaning. Results There was no significant difference between the three groups as regards demographic data, cause of admission or baseline characters at the start of randomization. The weaning duration of PSV+ATC group was significantly lower than the other groups. The duration of weaning in the ATC group was lower than that in the PSV group. There was a higher trend towards successful extubation in PSV+ATC group than other groups but without statistically significant difference. Mortality and morbidity were lower in PSV+ATC group than other groups and were lower in the ATC group than the PSV group but without statistically significant difference. Conclusion In medical ICU patients, the weaning process can be successfully performed by ATC as an add-on feature to the existing modes or as a separate mode. Duration of weaning, total duration of mechanical ventilation and duration of ICU stay were significantly lower with ATC.


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