Breathing pattern associated with respiratory comfort during automatic tube compensation and pressure support ventilation in normal subjects

Abstract

PSV resulted in excessive tidal volumes and airflow, which was perceived as discomfort. This cannot be avoided by a delayed pressure rise but can be by the more comfortable ATC. ATC seems to adapt better to the ventilatory demand than PSV.

Proportional assist versus pressure support ventilation in patients with acute respiratory failure: Cardiorespiratory responses to artificially increased ventilatory demand*

“…This table contains the ventilatory parameters and respiratory mechanics. support to patients' actual demands than constant PSV and that this will improve patient-ventilator interaction and comfort of breathing (31)(32)(33)(34). In this study, we investigated cardiorespiratory effects of different modalities of inspiratory pressure assistance in patients with ARF during normal breathing and after increasing ventilatory demand.…”

New Aspects in Mechanical Ventilation

“…As of yet, ATC has been associated with certain benefits for the tracheally intubated spontaneously breathing patient. Among these, reduced work of breathing [47,48], preservation of the natural "noisy" breathing pattern [46][47][48][49], enhanced synchronization between the patient and the ventilator [46,50], and improved respiratory comfort [49,51] seem to be the most important. Moreover, sufficient spontaneous breathing with ATC alone, i.e., without any additional ventilatory assist, might help to predict more accurately the readiness for extubation in the last phase of weaning from mechanical ventilation [52].…”

“Proportional assist ventilation” kombiniert mit “automatic tube compensation”

“…Dies erklärt vermutlich auch den höheren Patientkomfort, der für die Kombination von PAV und ATC im Vergleich zu PSV gezeigt werden konnte. Im Gegensatz dazu kann es während PSV zu Dyskomfort kommen, wenn der unterstützende Druck entweder zu hoch ist oder der Patient/Proband bei zu niedriger inspiratorischer Unterstützung weiterhin Dyspnoe empfindet [10,14,15,16].…”