Respiratory muscle workload in intubated, spontaneously breathing patients without COPD: pressure support vs proportional assist ventilation.

Details

Serval ID
serval:BIB_06EFC1AA7554
Type
Article: article from journal or magazin.
Collection
Publications
Title
Respiratory muscle workload in intubated, spontaneously breathing patients without COPD: pressure support vs proportional assist ventilation.
Journal
Intensive Care Medicine
Author(s)
Delaere S., Roeseler J., D'hoore W., Matte P., Reynaert M., Jolliet P., Sottiaux T., Liistro G.
ISSN
0342-4642 (Print)
ISSN-L
0342-4642
Publication state
Published
Issued date
2003
Peer-reviewed
Oui
Volume
29
Number
6
Pages
949-954
Language
english
Notes
Publication types: Comparative Study ; Journal ArticlePublication Status: ppublish
Abstract
OBJECTIVE: To compare the respiratory muscle workload associated with pressure support ventilation (PSV) and proportional assist ventilation (PAV) in intubated and spontaneously breathing patients without COPD.
DESIGN AND SETTING: Prospective study, intensive care unit university hospital.
INTERVENTIONS: Twenty intubated patients, during early weaning, PSV settings made by clinician in charge of the patient, and two levels of PAV, set to counterbalance 80% (PAV 80) and 50% (PAV 50) of both elastic and resistive loads, respectively. The patients were ventilated in the following order: 1) PSV; 2) PAV 50 or PAV 80; 3) PSV; 4) PAV 80 or PAV 50; 5) PSV. PSV settings were kept constant.
MEASUREMENTS: Arterial blood gases, breathing pattern and respiratory effort parameters at the end of each of the five steps.
MAIN RESULTS: PSV and PAV 80 had the same effects on work of breathing (WOB). The pressure-time product (PTP) was significantly higher during PAV 80 than during PSV (90+/-76 and 61+/-56 cmH(2)O.s.min(-1), respectively, P <0.05). Tidal volume was comparable, albeit more variable with PAV 80 than with PSV (variation coefficient, 43% vs 25%, respectively, P <0.05). PAV 50 entailed a higher respiratory rate, lower tidal volume, and higher WOB and PTP than PSV and PAV 80. PaO(2)/FiO(2) and SaO(2) were lower with PAV 50 than with PSV and PAV 80.
CONCLUSION: In a group of intubated spontaneously breathing non-COPD patients, PAV 80 and PSV were associated with comparable levels WOB, whereas PTP was higher during PAV 80. PAV 50 provided insufficient respiratory assistance.
Keywords
Adult, Aged, Aged, 80 and over, Airway Resistance, Blood Gas Analysis, Female, Forced Expiratory Flow Rates, Humans, Intermittent Positive-Pressure Ventilation/methods, Lung Compliance, Male, Middle Aged, Positive-Pressure Respiration/methods, Prospective Studies, Pulmonary Disease, Chronic Obstructive/complications, Pulmonary Gas Exchange, Respiratory Insufficiency/complications, Respiratory Insufficiency/metabolism, Tidal Volume, Treatment Outcome, Work of Breathing
Pubmed
Web of science
Create date
27/06/2013 14:40
Last modification date
20/08/2019 12:29
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