Physiologic comparison of neurally adjusted ventilator assist, proportional assist and pressure support ventilation in critically ill patients

Respiratory Physiology and Neurobiology

Volumn 203, Issue , 2014, Pages 82-89

  Akoumianaki, Evangelia ^a   Prinianakis, George ^a   Kondili, Eumorfia ^a   Malliotakis, Polychronis ^a   Georgopoulos, Dimitris ^a  

^a UNIVERSITY HOSPITAL OF HERAKLION   (Greece)

Author keywords

Inspiratory effort; Patient ventilator asynchrony; Transdiaphragmatic pressure

Indexed keywords

ADULT; AGED; AIRWAY PRESSURE; ARTICLE; ARTIFICIAL VENTILATION; ASSISTED VENTILATION; BREATHING MECHANICS; BREATHING MUSCLE; BREATHING PATTERN; CHRONIC OBSTRUCTIVE LUNG DISEASE; CLINICAL ARTICLE; CONTINUOUS VENTILATOR; CONTROLLED STUDY; COUGHING; CRITICALLY ILL PATIENT; DIAPHORESIS; DIAPHRAGM; ELECTRIC ACTIVITY; FEMALE; GAS EXCHANGE; HUMAN; INTENSIVE CARE; INTERMETHOD COMPARISON; MALE; MECHANICAL VENTILATOR; MIDDLE AGED; NEURALLY ADJUSTED VENTILATOR ASSIST; POSITIVE END EXPIRATORY PRESSURE; POSITIVE END EXPIRATORY PRESSURE VENTILATOR; PRESSURE SUPPORT VENTILATION; PROPORTIONAL ASSIST VENTILATION; RESPIRATORY ACIDOSIS; RESPIRATORY DISTRESS; RESPIRATORY SYSTEM; STEADY STATE; TACHYPNEA; TIDAL VOLUME; TRANSTRACHEAL CATHETER; VERY ELDERLY; COMPARATIVE STUDY; CRITICAL ILLNESS; EXERCISE; LUNG GAS EXCHANGE; NURSING; PHYSIOLOGY; PROCEDURES; STATISTICS; TREATMENT OUTCOME;

AGED; AGED, 80 AND OVER; CRITICAL ILLNESS; FEMALE; HUMANS; MALE; MIDDLE AGED; PHYSICAL EXERTION; PULMONARY GAS EXCHANGE; RESPIRATION, ARTIFICIAL; RESPIRATORY MECHANICS; STATISTICS AS TOPIC; TREATMENT OUTCOME; VENTILATORS, MECHANICAL;

EID: 84907706377     PISSN: 15699048     EISSN: 18781519     Source Type: Journal    
DOI: 10.1016/j.resp.2014.08.012     Document Type: Article

References (41)

1. Akoumianaki E., Kondili E., Georgopoulos D. Proportional assist ventilation. Eur. Respir. Mon. 2012, 55:97-115.
2. Alexopoulou C., Kondili E., Plataki M., Georgopoulos D. Patient-ventilator synchrony and sleep quality with proportional assist and pressure support ventilation. Intensive Care Med. 2013, 39:1040-1047.
3. Appendini L., Purro A., Gudjonsdottir M., Baderna P., Patessio A., Zanaboni S., Donner C.F., Rossi A. Physiologic response of ventilator-dependent patients with chronic obstructive pulmonary disease to proportional assist ventilation and continuous positive airway pressure. Am. J. Respir. Crit. Care Med. 1999, 159:1510-1517.
4. Beck J., Gottfried S.B., Navalesi P., Skrobik Y., Contois N., Rossini M., Sinderby C. Electrical activity of the diaphragm during pressure support ventilation in acute respiratory failure. Am. J. Respir. Crit. Care Med. 2001, 164:419-424.
5. Beck J., Sinderby C., Lindstrom L., Grassino A. Effects of lung volume on diaphragm EMG signal strength during voluntary contractions. J. Appl. Physiol. (1985) 1998, 85:1123-1134.
6. Bellani G., Mauri T., Coppadoro A., Grasselli G., Patroniti N., Spadaro S., Sala V., Foti G., Pesenti A. Estimation of patient's inspiratory effort from the electrical activity of the diaphragm. Crit. Care Med. 2013, 41:1483-1491.
7. Boles J.M., Bion J., Connors A., Herridhe M., Marsh B., Melot C., Pearl R., Silverman H., Stanchina M., Vieillard-Baron A., Welte T. Weaning from mechanical ventilation. Eur. Respir. J. 2007, 29:1033-1056.
8. Bosma K., Ferreyra G., Ambrogio C., Pasero D., Mirabella L., Braghiroli A., Appendini L., Mascia L., Ranieri V.M. Patient-ventilator interaction and sleep in mechanically ventilated patients: pressure support versus proportional assist ventilation. Crit. Care Med. 2007, 35:1048-1054.
9. Coisel Y., Chanques G., Jung B., Constantin J.M., Capdevila X., Matecki S., Grasso S., Jaber S. Neurally adjusted ventilatory assist in critically ill postoperative patients: a crossover randomized study. Anesthesiology 2010, 113:925-935.
10. Colombo D., Cammarota G., Bergamaschi V., De Lucia M., Corte F.D., Navalesi P. Physiologic response to varying levels of pressure support and neurally adjusted ventilatory assist in patients with acute respiratory failure. Intensive Care Med. 2008, 34:2010-2018.
11. Costa R., Spinazzola G., Cipriani F., Ferrone G., Festa O., Arcangeli A., Antonelli M., Proietti R., Conti G. A physiologic comparison of proportional assist ventilation with load-adjustable gain factors (PAV+) versus pressure support ventilation (PSV). Intensive Care Med. 2011, 37:1494-1500.
12. D'Angelo E., Robatto F.M., Calderini E., Tavola M., Bono D., Torri G., Milic-Emili J. Pulmonary and chest wall mechanics in anesthetized paralyzed humans. J. Appl. Physiol. (1985) 1991, 70:2602-2610.
13. Delaere S., Roeseler J., D'Hoore W., Matte P., Reynaert M., Jolliet P., Sottiaux T., Liistro G. Respiratory muscle workload in intubated, spontaneously breathing patients without COPD: pressure support vs proportional assist ventilation. Intensive Care Med. 2003, 29:949-954.
14. Fauroux B., Hart N., Luo Y.M., MacNeill S., Moxham J., Lofaso F., Polkey M.I. Measurement of diaphragm loading during pressure support ventilation. Intensive Care Med. 2003, 29:1960-1966.
15. Finucane K.E., Singh B. Human diaphragm efficiency estimated as power output relative to activation increases with hypercapnic hyperpnea. J. Appl. Physiol. (1985) 2009, 107:1397-1405.
16. 2. Am. J. Respir. Crit. Care Med. 1997, 155:2000-2009.
17. Georgopoulos D., Prinianakis G., Kondili E. Bedside waveforms interpretation as a tool to identify patient-ventilator asynchronies. Intensive Care Med. 2006, 32:34-47.
18. Georgopoulos D., Plataki M., Prinianakis G., Kondili E. Current status of proportional assist ventilation. Int. J. Intensive Care Med. 2007, 14:74-80.
19. Grasso S., Puntillo F., Mascia L., Ancona G., Fiore T., Bruno F., Slutsky A.S., Ranieri V.M. Compensation for increase in respiratory workload during mechanical ventilation. Pressure-support versus proportional-assist ventilation. Am. J. Respir. Crit. Care Med. 2000, 161:819-826.
20. Kacmarek R.M. Proportional assist ventilation and neurally adjusted ventilatory assist. Respir. Care 2011, 56:140-148. discussion 149-152.
21. Kondili E., Alexopoulou C., Xirouchaki N., Vaporidi K., Georgopoulos D. Estimation of inspiratory muscle pressure in critically ill patients. Intensive Care Med. 2010, 36:648-655.
22. Kondili E., Prinianakis G., Alexopoulou C., Vakouti E., Klimathianaki M., Georgopoulos D. Respiratory load compensation during mechanical ventilation--proportional assist ventilation with load-adjustable gain factors versus pressure support. Intensive Care Med. 2006, 32:692-699.
23. Kondili E., Prinianakis G., Anastasaki M., Georgopoulos D. Acute effects of ventilator settings on respiratory motor output in patients with acute lung injury. Intensive Care Med. 2001, 27:1147-1157.
24. Kondili E., Prinianakis G., Georgopoulos D. Patient-ventilator interaction. Br. J. Anaesth. 2003, 91:106-119.
25. Leung P., Jubran A., Tobin M.J. Comparison of assisted ventilator modes on triggering, patient effort, and dyspnea. Am. J. Respir. Crit. Care Med. 1997, 155:1940-1948.
26. Mutch W.A., Harms S., Ruth Graham M., Kowalski S.E., Girling L.G., Lefevre G.R. Biologically variable or naturally noisy mechanical ventilation recruits atelectatic lung. Am. J. Respir. Crit. Care Med. 2000, 162:319-323.
27. Piquilloud L., Vignaux L., Bialais E., Roeseler J., Sottiaux T., Laterre P.F., Jolliet P., Tassaux D. Neurally adjusted ventilatory assist improves patient-ventilator interaction. Intensive Care Med. 2011, 37:263-271.
28. Puddy A., Younes M. Effect of slowly increasing elastic load on breathing in conscious humans. J. Appl. Physiol. (1985) 1991, 70:1277-1283.
29. Ranieri V.M., Giuliani R., Mascia L., Grasso S., Petruzzelli V., Puntillo N., Perchiazzi G., Fiore T., Brienza A. Patient-ventilator interaction during acute hypercapnia: pressure-support vs. proportional-assist ventilation. J. Appl. Physiol. (1985) 1996, 81:426-436.
30. Ranieri V.M., Grasso S., Mascia L., Martino S., Fiore T., Brienza A., Giuliani R. Effects of proportional assist ventilation on inspiratory muscle effort in patients with chronic obstructive pulmonary disease and acute respiratory failure. Anesthesiology 1997, 86:79-91.
31. Sinderby C., Navalesi P., Beck J., Skrobik Y., Comtois N., Friberg S., Gottfried S.B., Lindstrom L. Neural control of mechanical ventilation in respiratory failure. Nat. Med. 1999, 5:1433-1436.
32. Spahija J., de Marchie M., Albert M., Bellemare P., Delisle S., Beck J., Sinderby C. Patient-ventilator interaction during pressure support ventilation and neurally adjusted ventilatory assist. Crit. Care Med. 2010, 38:518-526.
33. Thille A.W., Lyazidi A., Richard J.C., Galia F., Brochard L. A bench study of intensive-care-unit ventilators: new versus old and turbine-based versus compressed gas-based ventilators. Intensive Care Med. 2009, 35:1368-1376.
34. Tobin M.J. Advances in mechanical ventilation. N. Engl. J. Med. 2003, 344:1986-1996.
35. Varelmann D., Wrigge H., Zinserling J., Muders T., Hering R., Putensen C. Proportional assist versus pressure support ventilation in patients with acute respiratory failure: cardiorespiratory responses to artificially increased ventilatory demand. Crit. Care Med. 2005, 33:1968-1975.
36. Wrigge H., Golisch W., Zinserling J., Sydow M., Almeling G., Burchardi H. Proportional assist versus pressure support ventilation: effects on breathing pattern and respiratory work of patients with chronic obstructive pulmonary disease. Intensive Care Med. 1999, 25:790-798.
37. Wysocki M., Cracco C., Teixeira A., Mercat A., Diehl J.L., Lefort Y., Derenne J.P., Similowski T. Reduced breathing variability as a predictor of unsuccessful patient separation from mechanical ventilation. Crit. Care Med. 2006, 34:2076-2083.
38. Xirouchaki N., Kondili E., Vaporidi K., Xirouchakis G., Klimathianaki M., Gavriilidis G., Alexandropoulou E., Plataki M., Alexopoulou C., Georgopoulos D. Proportional assist ventilation with load-adjustable gain factors in critically ill patients: comparison with pressure support. Intensive Care Med. 2008, 34:2026-2034.
39. Younes M. Proportional assist ventilation, a new approach to ventilatory support. Theory. Am. Rev. Respir. Dis. 1992, 145:114-120.
40. Younes M., Kun J., Masiowski B., Webster K., Roberts D. A method for noninvasive determination of inspiratory resistance during proportional assist ventilation. Am. J. Respir. Crit. Care Med. 2001, 163:829-839.
41. Younes M., Webster K., Kun J., Roberts D., Masiowski B. A method for measuring passive elastance during proportional assist ventilation. Am. J. Respir. Crit. Care Med. 2001, 164:50-60.