scholarly journals Automatic tube compensation combined with pressure support ventilation - improved work of breathing pattern and less work

Critical Care ◽  
10.1186/cc830 ◽  
2000 ◽  
Vol 4 (Suppl 1) ◽  
pp. P110 ◽  
Author(s):  
P Singer ◽  
J Cohen ◽  
A Abraham ◽  
E Grozovsky
Keyword(s):  
Pressure Support Ventilation ◽  
Pressure Support ◽  
Breathing Pattern ◽  
Work Of Breathing ◽  
Support Ventilation ◽  
Tube Compensation

scholarly journals Continuous assessment of neuro-ventilatory drive during 12 hours of pressure support ventilation in critically ill patients 

2020 ◽  
Author(s):  
Rosa Di Mussi ◽  
Savino Spadaro ◽  
Carlo Alberto Volta ◽  
Nicola Bartolomeo ◽  
Paolo Trerotoli ◽  
...  
Keyword(s):  
Critically Ill ◽  
Critically Ill Patients ◽  
Pressure Support Ventilation ◽  
Pressure Support ◽  
Breathing Pattern ◽  
Continuous Assessment ◽  
Support Ventilation ◽  
Pressure Time ◽  
Ventilatory Drive ◽  
Patient At Risk

Abstract Introduction: Pressure support ventilation (PSV) should allow spontaneous breathing with a “normal” neuro-ventilatory drive. Low neuro-ventilatory drive puts the patient at risk of diaphragmatic atrophy while high neuro-ventilatory drive may causes dyspnea and patient self-inflicted lung injury. We continuously assessed for 12 hours the electrical activity of the diaphragm (EAdi), a close surrogate of neuro-ventilatory drive, during PSV. Our aim was to document the EAdi trend and the occurrence of periods of “Low” and/or “High” neuro-ventilatory drive during clinical application of PSV. Method: In 16 critically ill patients ventilated in the PSV mode for clinical reasons, inspiratory peak EAdi peak (EAdiPEAK), pressure time product of the trans-diaphragmatic pressure per breath and per minute (PTPDI/b and PTPDI/min, respectively), breathing pattern and major asynchronies were continuously monitored for 12 hours (from 8 a.m. to 8 p.m.). We identified breaths with “Normal” (EAdiPEAK 5 - 15 mV), “Low” (EAdiPEAK < 5 mV) and “High” (EAdiPEAK >15 mV) neuro-ventilatory drive. Results: Within all the analyzed breaths (177.117), the neuro-ventilatory drive, as expressed by the EAdiPEAK, was “Low” in 50.116 breath (28 %), “Normal” in 88.419 breaths (50 %) and “High” in 38.582 breaths (22 %). The average times spent in “Low”, “Normal” and “High” class were 1.37, 3.67 and 0,55 hours, respectively (p < 0.0001), with wide variations among patients. Eleven patients remained in the “Low” neuro-ventilatory drive class for more than one hour, median 6.1 [3.9 - 8.5] hours and 6 in the “High” neuro-ventilatory drive class, median 3.4 [2.2 – 7.8] hours. The asynchrony index was significantly higher in the “Low” neuro-ventilatory class, mainly because of a higher number of missed efforts. Conclusions: We observed wide variations in EAdi amplitude and unevenly distributed “Low” and “High” neuro ventilatory drive periods during 12 hours of PSV in critically ill patients. Further studies are needed to assess the possible clinical implications of our physiological findings.

EXTUBATING AT A PRESSURE-SUPPORT VENTILATION LEVEL CORRESPONDING TO ZERO IMPOSED WORK OF BREATHING

1994 ◽  
Vol 81 (SUPPLEMENT) ◽  
pp. A272
Author(s):  
M. J. Banner ◽  
A. Gabrielli ◽  
R. R. Kirby ◽  
A. J. Layon ◽  
T. J. Gallagher
Keyword(s):  
Pressure Support Ventilation ◽  
Pressure Support ◽  
Work Of Breathing ◽  
Support Ventilation
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