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

Détails

ID Serval
serval:BIB_06EFC1AA7554
Type
Article: article d'un périodique ou d'un magazine.
Collection
Publications
Titre
Respiratory muscle workload in intubated, spontaneously breathing patients without COPD: pressure support vs proportional assist ventilation.
Périodique
Intensive Care Medicine
Auteur⸱e⸱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
Statut éditorial
Publié
Date de publication
2003
Peer-reviewed
Oui
Volume
29
Numéro
6
Pages
949-954
Langue
anglais
Notes
Publication types: Comparative Study ; Journal ArticlePublication Status: ppublish
Résumé
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.
Mots-clé
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
Création de la notice
27/06/2013 14:40
Dernière modification de la notice
20/08/2019 12:29
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