Ventilatory support in critically ill patients Invasive ventilation, automated ventilation and oxygen support

Critically ill patients with respiratory failure often require oxygen support and invasive or noninvasive mechanical ventilation in the intensive care unit (ICU). This thesis comprises a collection of studies on ventilator management and oxygen use in critically ill patients with coronavirus disease 2019 (COVID–19) and automated ventilation in critically ill patients in general.
The first part of the thesis presents retrospective observational studies that were performed in critically ill COVID–19 patients. We described the ventilation practices and outcomes during the initial months of the COVID–19 pandemic in the Netherlands. Additionally, we investigated the prevalence of hyperoxemia and excessive oxygen use and their association with outcomes. In an international multicenter cohort of critically ill COVID–19 patients during the second wave of the outbreak, we described differences in oxygen use during high flow nasal oxygen (HFNO) therapy and mechanical ventilation.
The second part of this thesis focuses on automated invasive mechanical ventilation in critically ill patients. We investigated effectiveness, safety and efficacy of a mode of automated ventilation named INTELLiVENT–ASV through a systematic review. Furthermore, we compared in an international multicenter cross–over trial conventional ventilation and automated mechanical ventilation by means of INTELLiVENT–ASV with regard to oxygenation settings, alarms and manual interventions related to oxygenation.