Mechanical ventilation and the total artificial heart: Optimal ventilator trigger to avoid post-operative autocycling - a case series and literature review

Allen B. Shoham, Bhavesh Patel, Francisco A. Arabia, Michael J. Murray

Research output: Contribution to journalArticle

10 Scopus citations

Abstract

Many patients with end-stage cardiomyopathy are now being implanted with Total Artificial Hearts (TAHs). We have observed individual cases of post-operative mechanical ventilator autocycling with a flow trigger, and subsequent loss of autocycling after switching to a pressure trigger. These observations prompted us to do a retrospective review of all TAH devices placed at our institution between August 2007 and May 2009. We found that in the immediate post-operative period following TAH placement, autocycling was present in 50% (5/10) of cases. There was immediate cessation of autocycling in all patients after being changed from a flow trigger of 2 L/minute to a pressure trigger of 2 cm H 2 O. The autocycling group was found to have significantly higher CVP values than the non-autocycling group (P = 0.012). Our data suggest that mechanical ventilator autocycling may be resolved or prevented by the use of a pressure trigger rather than a flow trigger setting in patients with TAHs who require mechanical ventilation.

Original languageEnglish (US)
Article number39
JournalJournal of Cardiothoracic Surgery
Volume5
Issue number1
DOIs
StatePublished - May 17 2010

ASJC Scopus subject areas

  • Surgery
  • Pulmonary and Respiratory Medicine
  • Cardiology and Cardiovascular Medicine

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