Setting expiratory trigger at a higher percentage of peak inspiratory flow in patients with obstructive disease during pressure support improves patient-ventilator synchrony and reduces inspiratory muscle effort. Further studies should explore whether these effects can influence patient outcome.
Regarding trigger sensitivity and the system's ability to meet inspiratory flow during pressure-supported breaths, the most recent anesthesia ventilators have comparable performances of recent-generation intensive care unit ventilators.
These results suggest that the alveolar ventilation based automatic control of PS during NIV with a bilevel device is feasible and leads to beneficial effects in patients with acute respiratory failure comparable to those of manually set PS. Further studies should now explore the potential of this system over longer periods in patients with acute and chronic respiratory failure.
In intubated COPD patients ventilated with pressure support He/O2 reduces intrinsic PEEP, the number of ineffective breaths, and the magnitude of inspiratory effort and WOB. He/O2 could prove useful in patients with high levels of PEEPi and WOB ventilated in pressure support, for example, during weaning.
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