Guidelines on setting the target minute ventilation in Adaptive Support Ventilation

Adaptive Support Ventilation (ASV) is a fully closed loop ventilation where the operator input the desired PEEP, FiO2 and the target minute ventilation (MV) expressed as a percentage according to ideal body weight. The ventilator selects the target respiratory pattern (tidal volume, respiratory rate, and inspiratory time) based on the observed respiratory mechanics. However, there are no published guidelines on settings and adjusting the target MV in different disease states during ASV ventilation. INTELLiVENT-ASV, is the new generation modified algorithm of ASV, has made this issue much easier and simpler as the operator inputs a desired range of the end tidal exhaled carbon dioxide, and oxygen saturation and the algorithm will adjust the minute ventilation percentage as well as PEEP and FiO2 automatically to stay within that range. In this article we describe some evidence-based guidelines on how to set and adjust the target MV in various clinical conditions. Keywords: ASV, INTELLiVENT-ASV, Closed loop ventilation, End tidal CO2, ARDS, COPD, Respiratory failure