Comparison of proportional assist ventilation and pressure support ventilation in chronic respiratory failure due to neuromuscular and chest wall deformity

Hart, N.; Hunt, A.; Polkey, M.I.; Fauroux, B.; Lofaso, F.; Simonds, A.K.
November 2002
Thorax;Nov2002, Vol. 57 Issue 11, p979
Academic Journal
Background: The physiological and symptomatic effects of proportional assist ventilation (PAV) and pressure support ventilation (PSV) were compared in stable awake patients with neuromuscular and chest wall deformity (NMCWD). Methods: Oxygen saturation (SaO[sub 2]), transcutaneous carbon dioxide (TcCO[sub 2]), minute ventilation (V[sub E]), tidal volume (V[sub T]), respiratory rate (RR), and diaphragm electromyography (EMGdi) were measured in 15 patients during both modes. Subjective effort of breathing and synchrony with the ventilator were assessed using visual analogue scales. Results: Three of 15 patients failed to trigger the ventilator in either mode and were excluded. In the 12 remaining patients there were similar improvements in SaO[sub 2], TcCO[sub 2], V[sub E], V[sub T], and RR during both modes. The mean (SD) percentage fall in EMGdi was greater during PSV (-80.5 (10.7)%) than during PAV (-41.3 (35.2)%; p = 0.01). Effort of breathing (p=0.004) and synchrony with the ventilator (p=0.004) were enhanced more with PSV than with PAV. Conclusion: Both PSV and PAV produced similar improvements in physiological parameters. However, greater diaphragm unloading was observed with PSV than with PAV, associated with greater symptomatic benefit. These findings suggest that tolerance to PAV may be compromised in patients with NMCWD.


Related Articles

  • Noninvasive Positive Pressure Ventilation in Acute Respiratory Failure of Chronic Obstructive Pulmonary Disease. Clark, H.E.; Wilcox, P.G. // Lung;1997, Vol. 175 Issue 3, p143 

    Noninvasive positive pressure ventilation (NPPV) has reemerged as an effective strategy for reducing morbidity and mortality associated with acute exacerbations of chronic obstructive pulmonary disease (COPD). During acute respiratory failure, dynamic hyperinflation, intrinsic PEEP, and...

  • Strategies for Weaning the COPD Patient. Keane, Maureen // AARC Times;Apr2011, Vol. 35 Issue 4, p16 

    The article offers information on weaning procedures for patients with chronic obstructive pulmonary disease (COPD). It says that procedures must start when the need for ventilation was done or significantly improved and assess readiness of COPD patients to wean. It also mentions that it is...

  • Diagnosing Ventilator-Associated Pneumonia. Torres, Antoni; Ewig, Santiago // New England Journal of Medicine;1/29/2004, Vol. 350 Issue 5, p433 

    Reports on how the establishment of an appropriate diagnosis of ventilator-associated pneumonia is one of the most crucial and difficult issues in the care of critically ill patients. Dangers in the postponement by physicians in making a diagnosis and starting treatment.

  • Soluble Triggering Receptor Expressed on Myeloid Cells and the Diagnosis of Pneumonia. Gibot, Sébastien; Cravoisy, Aurélie; Levy, Bruno; Bene, Marie-Christine; Faure, Gilbert; Bollaert, Pierre-Edouard // New England Journal of Medicine;1/29/2004, Vol. 350 Issue 5, p451 

    Background: The diagnosis and treatment of bacterial pneumonia in patients who are receiving mechanical ventilation remain a difficult challenge. The triggering receptor expressed on myeloid cells (TREM-1) is a member of the immunoglobulin superfamily, and its expression on phagocytes is...

  • How the Use of Bundles Improves Reliability, Quality and Safety. Litch, Bonnie // Healthcare Executive;Mar/Apr2007, Vol. 22 Issue 2, p12 

    The article discusses the use of bundles in improving reliability, quality, and patient safety at Baptist Memorial Hospital-DeSoto in Southaven, Mississippi. Bundle is defined as a group of precautionary steps that when executed collectively has a positive effect on patient outcomes. Bundling...

  • Respiratory Infections.  // Current Medical Literature: Respiratory Medicine;2008, Vol. 22 Issue 4, p98 

    The article presents abstracts related to respiratory infections which include the use of silver-coated endotracheal tubes to treat ventilator-associated pneumonia (VAP), the benefits of flu vaccination on elderly individuals and the increased cases of tuberculosis (TB) cases occurred in...

  • Pulmonary ventilation in air conditioner users in Pravara Rural Hospital. Sabade, S. B.; Vikhe, B. B.; Borade, N. G. // Pravara Medical Review;2013, Vol. 5 Issue 2, p4 

    To study the effect of air conditioner (AC) on pulmonary functions in Pravara Rural Hospital and Medical College, Loni (Maharashtra), 60 healthy males between the ages of 25-40 years were considered. Among these, 30 were AC users (at least 06 hours /day), since last 06 months and were considered...

  • Prognostic value of midregional pro-atrial natriuretic peptide in ventilator-associated pneumonia. Seligman, Renato; Papassotiriou, Jana; Morgenthaler, Nils; Meisner, Michael; Teixeira, Paulo // Intensive Care Medicine;Nov2008, Vol. 34 Issue 11, p2084 

    This study aimed to investigate the correlation of midregional pro-atrial natriuretic peptide (MR-proANP) with severity of septic status in patients with ventilator-associated pneumonia (VAP) and the usefulness of MR-proANP for mortality prediction in VAP. Prospective observational cohort study....

  • High-Frequency Percussive Ventilation: Pneumotachograph Validation and Tidal Volume Analysis. Allan, Patrick F. // Respiratory Care;Jun2010, Vol. 55 Issue 6, p734 

    INTRODUCTION: High-frequency percussive ventilation (HFPV) is an increasingly used mode of mechanical ventilation, for which there is no proven real-time means of measuring delivered tidal volume (VT). OBJECTIVE: To validate a pneumotachograph for HFPV and then exploit flowsensor data to...


Read the Article


Sign out of this library

Other Topics