Although termination criterion (TC) is usually nonadjustable, it influences the effectiveness of pressure support ventilation for mechanical ventilation. The proper adjustment of TC is crucial to improve patient-ventilator synchrony and decrease work of breathing. TC 5% of the peak inspiratory flow may be the optimal value for patients with acute respiratory distress syndrome or acute lung injury.
We assessed the effect of pressure support ventilation (PSV) on breathing patterns and the work of breathing in 10 postoperative patients. Minute ventilation (VE) increased by 8% with 5 cm H2O PSV and 10% with 10 cm H2O PSV compared to 0 cm H2O PSV. The increase in VE was achieved by increased mean inspiratory flow (24% with 5 cm H2O PSV and 67% with 10 cm H2O PSV) and a decrease in duty cycle (13% with 5 cm H2O PSV and 39% with 10 cm H2O PSV). The decrease in duty cycle along with a decrease in respiratory frequency allowed a greater expiratory time including a rest period for the respiratory muscles, which might minimize the risk of muscle fatigue. Furthermore, the inspiratory work added by the ventilator was near zero with 5 cm H2O PSV and 10 cm H2O PSV. Oxygen consumption also decreased significantly with 5 cm H2O PSV. We conclude that PSV improves the breathing patterns and minimizes the work of breathing spontaneously via a ventilator.
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