常駐の専門医がいない集中治療室で肥満低換気症候群患者の心不全増悪時の管理にINTELLiVENT-adaptive support ventilation（I-ASV）モードが役立った1症例

INTELLiVENT-Adaptive Support Ventilation（I-ASV）Mode was Useful in Managing the Exacerbation of Acute Heart Failure in a Patient with Obesity Hypoventilation Syndrome in an ICU without Full-time Intensivists

要旨

　高度肥満患者の肥満低換気症候群の心不全増悪の人工呼吸管理にINTELLiVENT-adaptive support ventilation（I-ASV）を使用した。

　常駐専門医がいない当院集中治療室でpressure control ventilation-volume guarantee（PCV-VG）では連続した管理が困難でI-ASVに変更した。

　重症心不全に対し極端に高い換気設定とそれを適宜調整できる熟練度を要する本症例でI-ASVが代替マンパワーとして有効であった。

　INTELLiVENT^®-adaptive support ventilation（I-ASV, Hamilton Medical, Switzerland）, an advanced closed-loop ventilation mode for use in intensive care unit（ICU）patients, was recently used for the mechanical ventilation of a severely obese patient with obesity hypoventilation syndrome and exacerbation of heart failure. Our hospital’s ICU is not staffed with a resident specialist, and the continuous management of the patient was difficult with pressure control ventilation-volume guarantee（PCV-VG）；the management method was thus changed to I-ASV. We observed that I-ASV was effective in providing an alternative source of manpower in this case of severe heart failure that required extremely high ventilation settings and adjustment over time.