Evidence map›Paper›PMID 37611007›Full record

Trial reportPloS one2023

Closed-Loop ventilation using sidestream versus mainstream capnography for automated adjustments of minute ventilation-A randomized clinical trial in cardiac surgery patients.

Sunny G L H Nijbroek, Jan-Paul Roozeman, Sarah Ettayeby, Neeltje M Rosenberg, David M P van Meenen, Thomas G V Cherpanath, Wim K Lagrand, Robert Tepaske, Robert J M Klautz, Ary Serpa Neto and 1 more

Registry-linked trialOpen access · goldAbstract readRandomized Controlled TrialEquivalence Trial
In one paragraph

Trial report in PloS one, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT04599491 (INTELLiVENT-ASV Using Mainstream Versus Sidestream End-Tidal CO2 Monitoring- a Randomized Noninferiority Clinical Trial in Cardiac Surgery Patients), which is not on this map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
0.8field-weighted citation impact, top 24% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT04599491 nacompletednot on this map

INTELLiVENT-ASV Using Mainstream Versus Sidestream End-Tidal CO2 Monitoring- a Randomized Noninferiority Clinical Trial in Cardiac Surgery Patients

TypeinterventionalSponsorAcademisch Medisch Centrum - Universiteit van Amsterdam (AMC-UvA)Ran2020 to 2022Enrolled72ConditionsMechanical Ventilation Complication, Intensive Care Unit, Postoperative CareArmsSidestream capnography using the 'Respironics LoFlo Sidestream CO2 Module', Mainstream capnography using the 'Respironics Capnostat 5 Mainstream CO2 sensor'
3 · Its place in the literature

Who cites it

0 citing papers in PubMed, 3 citations in OpenAlex.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

11 authors at 5 institutions in 5 countries.

Sunny G L H NijbroekDepartment of Intensive Care, Amsterdam University Medical Centers, Location AMC, Amsterdam, The Netherlands.ORCID 0000-0002-9443-5659
Jan-Paul RoozemanDepartment of Intensive Care, Amsterdam University Medical Centers, Location AMC, Amsterdam, The Netherlands.
Sarah EttayebyDepartment of Intensive Care, Amsterdam University Medical Centers, Location AMC, Amsterdam, The Netherlands.
Neeltje M RosenbergDepartment of Intensive Care, Amsterdam University Medical Centers, Location AMC, Amsterdam, The Netherlands.
David M P van MeenenDepartment of Intensive Care, Amsterdam University Medical Centers, Location AMC, Amsterdam, The Netherlands.ORCID 0000-0002-6574-9034
Thomas G V CherpanathDepartment of Intensive Care, Amsterdam University Medical Centers, Location AMC, Amsterdam, The Netherlands.
Wim K LagrandDepartment of Intensive Care, Amsterdam University Medical Centers, Location AMC, Amsterdam, The Netherlands.
Robert TepaskeDepartment of Intensive Care, Amsterdam University Medical Centers, Location AMC, Amsterdam, The Netherlands.
Robert J M KlautzDepartment of Cardiothoracic Surgery, Amsterdam University Medical Centers, Location AMC, Amsterdam, The Netherlands.
Ary Serpa NetoDepartment of Intensive Care, Amsterdam University Medical Centers, Location AMC, Amsterdam, The Netherlands.
Marcus J SchultzDepartment of Intensive Care, Amsterdam University Medical Centers, Location AMC, Amsterdam, The Netherlands.
Amsterdam University Medical Centers · NLLeiden University Medical Center · NLMahidol University · THSpaarne Ziekenhuis · NLThe University of Melbourne · AU

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundINTELLiVENT-Adaptive Support Ventilation (ASV) is a closed-loop ventilation mode that uses capnography to adjust tidal volume (VT) and respiratory rate according to a user-set end-tidal CO2 (etCO2) target range. We compared sidestream versus mainstream capnography with this ventilation mode with respect to the quality of breathing in patients after cardiac surgery.

methodsSingle-center, single-blinded, non-inferiority, randomized clinical trial in adult patients scheduled for elective cardiac surgery that were expected to receive at least two hours of postoperative ventilation in the ICU. Patients were randomized 1:1 to closed-loop ventilation with sidestream or mainstream capnography. Each breath was classified into a zone based on the measured VT, maximum airway pressure, etCO2 and pulse oximetry. The primary outcome was the proportion of breaths spent in a predefined 'optimal' zone of ventilation during the first three hours of postoperative ventilation, with a non-inferiority margin for the difference in the proportions set at -20%. Secondary endpoints included the proportion of breaths in predefined 'acceptable' and 'critical' zones of ventilation, and the proportion of breaths with hypoxemia.

resultsOf 80 randomized subjects, 78 were included in the intention-to-treat analysis. We could not confirm the non-inferiority of closed-loop ventilation using sidestream with respect to the proportion of breaths in the 'optimal' zone (mean ratio 0.87 [0.77 to ∞]; P = 0.116 for non-inferiority). The proportion of breaths with hypoxemia was higher in the sidestream capnography group versus the mainstream capnography group.

conclusionsWe could not confirm that INTELLiVENT-ASV using sidestream capnography is non-inferior to INTELLiVENT-ASV using mainstream capnography with respect to the quality of breathing in subjects receiving postoperative ventilation after cardiac surgery.

trial registrationNCT04599491 (clinicaltrials.gov).

Indexed as

CapnographyCardiac Surgical ProceduresAdultHumansHypoxiaRespirationTidal Volume

Identifiers

PMID37611007
PMCPMC10446221
OpenAlexW4386090862

What OpenQuestion holds

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LicenceCC BY
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Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.