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Adaptive Support
Ventilation®(ASV®)
 Intelligent ventilation mode for passive and
spontaneously breathing adult and pediatric patients
 Automatically adjusts ventilation to lung mechanics and
applies lung-protective strategies
 Shortens ventilation time
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Ventilation adapted to the

patient
All Hamilton Medical ventilators feature the intelligent
ventilation mode Adaptive Support Ventilation (ASV). ASV
adjusts respiratory rate, tidal volume, and inspiratory time
continuously depending on the patient’s lung mechanics and
effort. ASV adapts ventilation breath-by-breath, 24 hours a
day, and from intubation to extubation.

ASV automatically employs lung-protective strategies to

minimize complications from AutoPEEP and
volutrauma/barotrauma. It also prevents apnea, tachypnea,
dead space ventilation, and excessively large breaths. Within
the rules of this lung-protective strategy, ASV encourages the
patient to breathe spontaneously.

ASV is a well established mode in critical care since 1998 and

has become a standard mode in many units around the
world. ASV has been successfully used in a variety of patient
groups — including post-operative, COPD, and ARDS patients
(Celli 2014, Agarwal 2013, Kirakli 2011, Gruber 2008, Sulzer
2001).

What customers say about

ASV
Dr. Olivier Seiler

Deputy Medical Director (till 2014)

Rega Air Ambulance, Zurich, Switzerland

ASV in particular has proven its worth in everyday use. Our

crews are highly enthusiastic about it. They say that they
don’t have to worry about the ventilation and can focus on
setting the patient up.
PreviousNext

Scientific evidence on ASV

Since its introduction in 1998, ASV has received a lot of

interest from the scientific community and has been the topic
of well over 30 studies.

Studies show that:

 In passive patients, ASV selects different tidal volume /

respiratory rate combinations for normal lung, COPD, and
ARDS patients (Arnal 2008).
 In active patients, ASV decreases work of breathing and
improves patient-ventilator synchrony (Wu 2010, Tassaux
2010).
 In the ICU, ASV decreases the weaning duration in
medical patients (Chen 2011) and COPD patients (Kirakli
2011).
 In post-cardiac surgery, ASV allows earlier extubation
than conventional modes (Gruber 2008, Sulzer 2001) with
fewer manual adjustments (Petter 2003) and fewer ABG
analyses performed (Sulzer 2001).
The bibliography gives an overview of the results of the
studies on ASV and of some of the underlying principles.

Adaptive Support Ventilation (ASV) bibliography

How ASV works

ASV maintains an operator set minute volume and
automatically determines an optimal tidal volume /
respiratory rate combination based on the minimal work of
breathing principle described by Otis (Otis 1954). ASV takes
into account the patient’s respiratory mechanics, which are
measured breath-by-breath by the proximal flow sensor. ASV
ensures optimal ventilation for each patient during passive
ventilation, spontaneous breathing, and weaning.
ASV in passive patients
In passive patients, ASV is a volume-targeted pressure
controlled mode with automatic adjustment of inspiratory
pressure, respiratory rate, and inspiratory/expiratory time
ratio. Maximum tidal volume is controlled by setting a
maximum inspiratory pressure. Expiratory time is determined
according to the expiratory time constant in order to prevent
dynamic hyperinflation.
ASV in active patients
In spontaneously breathing patients, ASV is a volume-
targeted pressure support mode with automatic adjustment
of pressure support according to the spontaneous respiratory
rate. The automatic decrease of pressure support when the
patient recovers their inspiratory strength is very useful for
weaning. ASV can also be used to perform a weaning trial
before extubation.

Availability of ASV
ASV is available on all current Hamilton Medical mechanical
ventilators.

See ventilator overview

References
Arnal J-M, Wysocki M, Nafati C, Donati S, Granier I, Corno G,
et al. Automatic selection of breathing pattern using adaptive
support ventilation. Intensive Care
Med. 2008 Jan;34(1):75-81.
Celli P, Privato E, Ianni S, Babetto C, D'Arena C, Guglielmo N,
Maldarelli F, Paglialunga G, Rossi M, Berloco PB, Ruberto F,
Pugliese F. Adaptive support ventilation versus synchronized
intermittent mandatory ventilation with pressure support in
weaning patients after orthotopic liver transplantation.
Transplant Proc. 2014 Sep;46(7):2272-8.
Chen C-W, Wu C-P, Dai Y-L, Perng W-C, Chian C-F, Su W-L, et
al. Effects of implementing adaptive support ventilation in a
medical intensive care unit. Respir
Care. 2011 Jul;56(7):976-983.
Gruber PC, Gomersall CD, Leung P, Joynt GM, Ng SK, Ho K-M,
et al. Randomized controlled trial comparing adaptive-support
ventilation with pressure-regulated volume-controlled
ventilation with automode in weaning patients after cardiac
surgery. Anesthesiology. 2008 Jul;109(1):81-87.
Iotti GA, Polito A, Belliato M, Pasero D, Beduneau G, Wysocki
M, et al. Adaptive support ventilation versus conventional
ventilation for total ventilatory support in acute respiratory
failure. Intensive Care Med. 2010 Aug;36(8):1371-1379.
Kirakli C, Ozdemir I, Ucar ZZ, Cimen P, Kepil S, Ozkan SA.
Adaptive support ventilation for faster weaning in COPD: a
randomised controlled trial. Eur Respir
J. 2011 Oct;38(4):774-780.
Otis AB. The work of breathing. Physiol
Rev. 1954 Jul;34(3):449-58
Petter AH, Chioléro RL, Cassina T, Chassot P-G, Müller XM,
Revelly J-P. Automatic « respirator/weaning » with adaptive
support ventilation: the effect on duration of endotracheal
intubation and patient management. Anesth
Analg. 2003 Dec;97(6):1743-1750.
Sulzer CF, Chioléro R, Chassot PG, Mueller XM, Revelly JP.
Adaptive support ventilation for fast tracheal extubation after
cardiac surgery: a randomized controlled study.
Anesthesiology. 2001 Dec;95(6):1339-1345.
Tassaux D, Dalmas E, Gratadour P, Jolliet P. Patient-ventilator
interactions during partial ventilatory support: a preliminary
study comparing the effects of adaptive support ventilation
with synchronized intermittent mandatory ventilation plus
inspiratory pressure support. Crit Care
Med. 2002 Apr;30(4):801-807.
Wu C-P, Lin H-I, Perng W-C, Yang S-H, Chen C-W, Huang Y-CT,
et al. Correlation between the %MinVol setting and work of
breathing during adaptive support ventilation in patients with
respiratory failure. Respir Care. 2010 Mar;55(3):334-341.

Ventilasi Dukungan
Adaptif ®(ASV ®
)
 Mode ventilasi cerdas untuk pasien dewasa dan anak-
anak pasif dan spontan bernapas
 Secara otomatis menyesuaikan ventilasi ke mekanik
paru-paru dan menerapkan strategi perlindungan paru-paru
 Memperpendek waktu ventilasi

Putar video

Ventilasi disesuaikan dengan

pasien
Semua ventilator Hamilton Medical memiliki mode ventilasi
cerdas Adaptive Support Ventilation (ASV). ASV
menyesuaikan laju pernapasan, volume tidal, dan waktu
inspirasi secara terus menerus tergantung pada mekanisme
dan upaya paru-paru pasien. ASV menyesuaikan ventilasi
napas-per-napas, 24 jam sehari, dan dari intubasi ke
ekstubasi.
ASV secara otomatis menggunakan strategi perlindungan
paru-paru untuk meminimalkan komplikasi dari AutoPEEP dan
volutrauma / barotrauma. Ini juga mencegah apnea,
takipnea, ventilasi ruang mati, dan napas yang terlalu
besar. Dalam aturan strategi perlindungan paru-paru ini, ASV
mendorong pasien untuk bernapas secara spontan.
ASV adalah mode mapan dalam perawatan kritis sejak tahun
1998 dan telah menjadi mode standar di banyak unit di
seluruh dunia. ASV telah berhasil digunakan dalam berbagai
kelompok pasien - termasuk pasien pasca operasi, COPD, dan
ARDS (Celli 2014, Agarwal 2013, Kirakli 2011, Gruber 2008,
Sulzer 2001).

Apa yang pelanggan katakan

tentang ASV
Ken Hargett

Direktur Perawatan Pernafasan

Rumah Sakit Methodist, Houston (TX), AS

ASV menyesuaikan dengan kebutuhan pasien dengan secara

terus-menerus menyesuaikan tekanan yang dibutuhkan
sambil mempertahankan kisaran ventilasi yang aman. Ini
memberikan semua tingkat ventilasi terlepas dari apa
kebutuhan pasien.
SebelumnyaSelanjutnya

Bukti ilmiah tentang ASV

Sejak diperkenalkan pada tahun 1998, ASV telah menerima
banyak minat dari komunitas ilmiah dan telah menjadi topik
lebih dari 30 penelitian.
Studi menunjukkan bahwa:
 Pada pasien pasif, ASV memilih kombinasi volume tidal /
laju pernapasan yang berbeda untuk pasien paru-paru
normal, PPOK, dan ARDS (Arnal 2008).
 Pada pasien aktif, ASV mengurangi kerja pernapasan dan
meningkatkan sinkronisasi pasien-ventilator (Wu 2010,
Tassaux 2010).
 Di ICU, ASV mengurangi durasi penyapihan pada pasien
medis (Chen 2011) dan pasien PPOK (Kirakli 2011).
 Dalam operasi pasca-jantung, ASV memungkinkan
ekstubasi lebih awal daripada mode konvensional (Gruber
2008, Sulzer 2001) dengan penyesuaian manual yang
 lebih sedikit (Petter 2003) dan lebih sedikit analisis ABG
yang dilakukan (Sulzer 2001).
Daftar pustaka memberikan gambaran umum tentang hasil
studi tentang ASV dan beberapa prinsip yang mendasarinya.
Bibliografi Ventilasi Dukungan Adaptif (ASV)

Bagaimana ASV bekerja

ASV mempertahankan volume set menit yang ditetapkan
operator dan secara otomatis menentukan kombinasi volume
tidal / laju pernapasan optimal berdasarkan prinsip kerja
minimal pernapasan yang dijelaskan oleh Otis (Otis
1954). ASV memperhitungkan mekanika pernapasan pasien,
yang diukur napas demi napas oleh sensor aliran
proksimal. ASV memastikan ventilasi optimal untuk setiap
pasien selama ventilasi pasif, pernapasan spontan, dan
menyapih.
ASV pada pasien pasif
Pada pasien pasif, ASV adalah mode pengontrolan tekanan
target volume dengan penyesuaian otomatis tekanan
inspirasi, laju pernapasan, dan rasio waktu inspirasi /
ekspirasi. Volume tidal maksimum dikontrol dengan
menetapkan tekanan inspirasi maksimum. Waktu ekspirasi
ditentukan berdasarkan konstanta waktu ekspirasi untuk
mencegah hiperinflasi dinamis.
ASV pada pasien aktif
Pada pasien yang bernafas spontan, ASV adalah mode
penunjang tekanan target volume dengan penyesuaian
otomatis penunjang tekanan sesuai dengan laju pernapasan
spontan. Penurunan dukungan tekanan otomatis ketika
pasien pulih kekuatan inspirasi mereka sangat berguna untuk
menyapih. ASV juga dapat digunakan untuk melakukan
percobaan penyapihan sebelum ekstubasi.

Ketersediaan ASV
ASV tersedia di semua ventilator mekanik Hamilton Medical
saat ini.