Variable Pressure Support, Proportional Assist And Conventional Pressure Support Ventilation: A Comprehensive Evaluation In Experimental Acute Lung Injury

2010 ◽  
Author(s):  
Andreas Güldner ◽  
Peter M. Spieth ◽  
Alessandro Beda ◽  
Nadja S. Carvalho ◽  
Anke Krause ◽  
...  
Keyword(s):  
Acute Lung Injury ◽  
Lung Injury ◽  
Pressure Support Ventilation ◽  
Pressure Support ◽  
Comprehensive Evaluation ◽  
Variable Pressure ◽  
Support Ventilation

Comparative effects of proportional assist and variable pressure support ventilation on lung function and damage in experimental lung injury*

2012 ◽  
Vol 40 (9) ◽  
pp. 2654-2661 ◽  
Author(s):  
Peter M. Spieth ◽  
Andreas Güldner ◽  
Alessandro Beda ◽  
Nadja Carvalho ◽  
Thomas Nowack ◽  
...  
Keyword(s):  
Lung Function ◽  
Lung Injury ◽  
Pressure Support Ventilation ◽  
Pressure Support ◽  
Variable Pressure ◽  
Support Ventilation

Short-term Cardiorespiratory Effects of Proportional Assist and Pressure-support Ventilation in Patients with Acute Lung Injury/Acute Respiratory Distress Syndrome

2006 ◽  
Vol 105 (4) ◽  
pp. 703-708 ◽  
Author(s):  
Eumorfia Kondili ◽  
Nectaria Xirouchaki ◽  
Katerina Vaporidi ◽  
Maria Klimathianaki ◽  
Dimitris Georgopoulos
Keyword(s):  
Acute Respiratory Distress Syndrome ◽  
Acute Lung Injury ◽  
Gas Exchange ◽  
Lung Injury ◽  
Respiratory Distress Syndrome ◽  
Pressure Support Ventilation ◽  
Pressure Support ◽  
Distress Syndrome ◽  
Short Term ◽  
Support Ventilation

Background Recent data indicate that assisted modes of mechanical ventilation improve pulmonary gas exchange in patients with acute lung injury (ALI)/acute respiratory distress syndrome (ARDS). Proportional assist ventilation (PAV) is a new mode of support that amplifies the ventilatory output of the patient effort and improves patient-ventilator synchrony. It is not known whether this mode may be used in patients with ALI/ARDS. The aim of this study was to compare the effects of PAV and pressure-support ventilation on breathing pattern, hemodynamics, and gas exchange in a homogenous group of patients with ALI/ARDS due to sepsis. Methods Twelve mechanically ventilated patients with ALI/ARDS (mean ratio of partial pressure of arterial oxygen to fractional concentration of oxygen 190 +/- 49 mmHg) were prospectively studied. Patients received pressure-support ventilation and PAV in random order for 30 min while maintaining mean airway pressure constant. With both modes, the level of applied positive end-expiratory pressure (7.1 +/- 2.1 cm H2O) was kept unchanged throughout. At the end of each study period, cardiorespiratory data were obtained, and dead space to tidal volume ratio was measured. Results With both modes, none of the patients exhibited clinical signs of distress. With PAV, breathing frequency and cardiac index were slightly but significantly higher than the corresponding values with pressure-support ventilation (24.5 +/- 6.9 vs. 21.4 +/- 6.9 breaths/min and 4.4 +/- 1.6 vs. 4.1 +/- 1.3 l . min . m, respectively). None of the other parameters differ significantly between modes. Conclusions In patients with ALI/ARDS due to sepsis, PAV and pressure-support ventilation both have clinically comparable short-term effects on gas exchange and hemodynamics.

scholarly journals Effects of sigh during pressure control and pressure support ventilation in pulmonary and extrapulmonary mild acute lung injury

Critical Care ◽  
2014 ◽  
Vol 18 (4) ◽  
Author(s):  
Lillian Moraes ◽  
Cíntia Lourenco Santos ◽  
Raquel Souza Santos ◽  
Fernanda Ferreira Cruz ◽  
Felipe Saddy ◽  
...  
Keyword(s):  
Acute Lung Injury ◽  
Lung Injury ◽  
Pressure Support Ventilation ◽  
Pressure Support ◽  
Pressure Control ◽  
Support Ventilation

scholarly journals Effects of Different Levels of Pressure Support Variability in Experimental Lung Injury

2009 ◽  
Vol 110 (2) ◽  
pp. 342-350 ◽  
Author(s):  
Peter M. Spieth ◽  
Alysson R. Carvalho ◽  
Andreas Güldner ◽  
Paolo Pelosi ◽  
Oleg Kirichuk ◽  
...  
Keyword(s):  
Acute Lung Injury ◽  
Lung Injury ◽  
Pressure Support Ventilation ◽  
Airway Pressure ◽  
Pressure Support ◽  
Inspiratory Effort ◽  
Peak Airway Pressure ◽  
Support Ventilation ◽  
Different Levels ◽  
Surfactant Depletion

Background Noisy pressure support ventilation has been reported to improve respiratory function compared to conventional assisted mechanical ventilation. We aimed at determining the optimal level of pressure support variability during noisy pressure support ventilation. Methods Twelve pigs were anesthetized and mechanically ventilated. Acute lung injury was induced by surfactant depletion. At four levels of pressure support variability (coefficients of variation of pressure support equal to 7.5, 15, 30, and 45%, 30 min each, crossover design, special Latin squares sequence), we measured respiratory variables, gas exchange, hemodynamics, inspiratory effort, and comfort of breathing. The mean level of tidal volume was constant among variability levels. Results Compared to conventional pressure support ventilation, different levels of variability in pressure support improved the elastance of the respiratory system, peak airway pressure, oxygenation, and intrapulmonary shunt. Oxygenation and venous admixture benefited more from intermediate (30%) levels of variability, whereas elastance and peak airway pressure improved linearly with increasing variability. Heart rate as well as mean arterial and pulmonary arterial pressures decreased slightly at intermediate to high (30-45%) levels of variability in pressure support. Inspiratory effort and comfort of breathing were not importantly influenced by increased variability in pressure support. Conclusion In a surfactant depletion model of acute lung injury, variability of pressure support improves lung function. The variability level of 30% seems to represent a reasonable compromise to improve lung functional variables during noisy pressure support ventilation.

Pressure support ventilation in patients with acute lung injury

2000 ◽  
Vol 28 (5) ◽  
pp. 1269-1275 ◽  
Author(s):  
Maurizio Cereda ◽  
Giuseppe Foti ◽  
Barbara Marcora ◽  
Mauro Gili ◽  
Matteo Giacomini ◽  
...  
Keyword(s):  
Acute Lung Injury ◽  
Lung Injury ◽  
Pressure Support Ventilation ◽  
Pressure Support ◽  
Support Ventilation
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