Clinical experience with Smart Care after off-pump coronary artery bypass for early extubation

Kataoka, Go; Murai, Noriyuki; Kodera, Kojiro; Sasaki, Akiko; Asano, Ryuta; Ikeda, Masahiro; Takeuchi, Yasuo

doi:10.1007/s10047-007-0392-1

Cited by 14 publications

(6 citation statements)

References 9 publications

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“…In Kataoka's and Naritaka's study (12,14) the authors found no side effects either. These findings were probably due to the frequent observations of SmartCare and the great experience of the physicians during and after the weaning process.…”

Section: Dþscussþonmentioning

confidence: 88%

“…SmartCare™ (SC) (Drager Medical, Lubeck, Germany) is a automated system, specifically designed to guide weaning and has been associated with a substantial reduction in the duration of ventilation. (9)(10)(11)(12)(13)(14) The aim of the study was to compare the extubation times of protocolized versus www.signavitae.com automated weaning from mechanical ventilation in patients after major surgery in the intensive care unit.…”

Section: Introductþonmentioning

confidence: 99%

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Comparison of extubation times between protocolized versus automated weaning systems after major surgery

2012

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Section: Dþscussþonmentioning

confidence: 88%

Section: Introductþonmentioning

confidence: 99%

Comparison of extubation times between protocolized versus automated weaning systems after major surgery

2012

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“…The SC was recently introduced to Japan, where its efficacy has sporadically been reported in the fields of both cardiovascular surgery and the intensive care unit [9][10] . The present study was performed to examine the efficacy of SC for weaning from the ventilator during postoperative respiratory management in patients surgically treated for esophageal carcinoma.…”

Section: Discussionmentioning

confidence: 99%

Clinical Experience with Smart Care for Respiratory Managementafter Esophageal Cancer Surgery

Naritaka

Shimakawa

Asaka

et al. 2009

Ann. Cancer Res. Therap.

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Smart Care® (SC) is an automated weaning system which has been newly installed in the Evita XL Ventilator made by Dräger Medical (Lubeck, Germany). This study was performed to investigate the application of SC to postoperative respiratory management in patients with esophageal cancer, for the purpose of more objectively assessing postoperative weaning from the ventilator, which has largely been performed based on the individual physician's experience. This study included 8 patients with cancer of the thoracic esophagus who were weaned postoperatively from the ventilator using SC. The weaning was performed by adjusting the ventilator automatically using SC to decrease the preset pressure support (PS) level to 7 cmH 2 O, using spontaneous respiratory rate (F spont), expiratory tidal volume (Vte) and end-tidal carbon dioxide pressure (etCO 2) as the assessment factors under the conditions of continuous positive airway pressure (CPAP) mode and a positive end expiratory pressure (PEEP) of 5 cm or less. In all 8 patients, weaning was accomplished with the display of the message "Consider Separation", in accordance with which the endotracheal tube was removed. The mean duration of intubation was 32 ± 4.0 hours, and that of SC use was 104.4 ± 42.8 minutes. SC proved remarkably useful in that all the patients had an uneventful course after the removal of the endotracheal tube and none required reintubation. It is expected in the future that the use of SC will enable the establishment of a uniform weaning protocol after esophageal cancer surgery, and this may contribute to the standardization and higher efficiency of postoperative respiratory management.

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“…After spontaneous breathing was confirmed, weaning was performed using the Smart Care function, which automatically determines the appropriate level of ventilator support. 13 This ventilation management strategy was used in both groups.…”

Section: What This Paper Contributes To Our Knowledgementioning

confidence: 99%

High-Flow Nasal Cannula Therapy With Early Extubation for Subjects Undergoing Off-Pump Coronary Artery Bypass Graft Surgery

Tatsuishi¹,

Sato²,

Kataoka³

et al. 2019

Respir Care

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BACKGROUND: The effects of high-flow nasal cannula (HFNC) therapy on postoperative atelectasis and duration of oxygen therapy after off-pump coronary artery bypass graft are unknown. The purpose of this study was to compare the effects of HFNC therapy for subjects who underwent off-pump coronary artery bypass graft with the effects of standard oxygen therapy in terms of oxygen requirement and atelectasis. METHODS: This prospective single-blinded randomized, controlled trial included 148 subjects who underwent off-pump coronary artery bypass graft between 2010 and 2015 with HFNC (n ‫؍‬ 72) or without HFNC (standard O 2 , n ‫؍‬ 76). The primary end point was the percentage difference in loss of lung volume between subjects with or without HFNC therapy. Secondary end points included the total amount of oxygen administered and duration of oxygen therapy with and without HFNC therapy. RESULTS: There were significant between-group differences in the percentage loss of lung volume (P < .001), total amount of oxygen administered (P < .001), duration of oxygen therapy (P < .001), and the need for postoperative diuretic therapy (P ‫؍‬ .037). The amount (‫؍‬ 0.569, P < .001) and duration (‫؍‬ 0.678, P < .001) of oxygen administered were correlated with atelectasis volume. CONCLUSIONS: Using HFNC therapy after off-pump coronary artery bypass graft shortened the duration of oxygen therapy and reduced the percentage loss of lung volume and total amount of oxygen administered when compared with standard oxygen therapy.

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Clinical experience with Smart Care after off-pump coronary artery bypass for early extubation

Cited by 14 publications

References 9 publications

Comparison of extubation times between protocolized versus automated weaning systems after major surgery

Comparison of extubation times between protocolized versus automated weaning systems after major surgery

Clinical Experience with Smart Care for Respiratory Managementafter Esophageal Cancer Surgery

High-Flow Nasal Cannula Therapy With Early Extubation for Subjects Undergoing Off-Pump Coronary Artery Bypass Graft Surgery

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