Patient-Ventilator Interaction With Noninvasive Proportional Assist Ventilation in Subjects With COPD.
BACKGROUND: To investigate patient-ventilator interaction during different levels of noninvasive proportional assist ventilation (PAV) compared with noninvasive pressure support ventilation (PSV). METHODS: Fifteen subjects with severe COPD and hypercapnia were consecutively recruited. After the base...
| Publicado en: | Respiratory Care Vol. 65; no. 1; pp. 45 - 53 |
|---|---|
| Autores principales: | , , |
| Formato: | research tables/charts randomized controlled trial Journal Article |
| Publicado: |
Mary Ann Liebert, Inc.
Jan2020
|
| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=141064441&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 141064441 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 00201324 4GG jtl: Respiratory Care issn: 00201324 maglogo: N pubinfo: dt: Jan2020 vid: 65 iid: 1 pid: 1365 pub: Mary Ann Liebert, Inc. place: New Rochelle, New York artinfo: ui: 141064441 141064441 141064441 10.4187/respcare.06430 141064441 ppf: 45 ppct: 8 formats: fmt: @attributes: type: P tig: atl: Patient-Ventilator Interaction With Noninvasive Proportional Assist Ventilation in Subjects With COPD. aug: au: Jianheng Zhang Qun Luo Rongchang Chen affil: State Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Disease, Guangzhou Institute of Respiratory Health, Guangzhou, China sug: subj: Respiration, Artificial Methods Pulmonary Disease, Chronic Obstructive Therapy Noninvasive Procedures Treatment Outcomes Human Hypercapnia Therapy Pressure Support Ventilation Airway Pressure Middle Age Aged Single-Blind Studies Randomized Controlled Trials Crossover Design Descriptive Statistics Analysis of Variance Post Hoc Analysis Friedman Test Data Analysis Software Comparative Studies Electromyography Methods Inspiration, Respiratory Middle Aged: 45-64 years Aged: 65+ years ab: BACKGROUND: To investigate patient-ventilator interaction during different levels of noninvasive proportional assist ventilation (PAV) compared with noninvasive pressure support ventilation (PSV). METHODS: Fifteen subjects with severe COPD and hypercapnia were consecutively recruited. After the baseline assessment of unassisted spontaneous breathing, 3 levels of ventilatory support were applied. The proportional assist (PA) and pressure support (PS) levels were set by subject comfort. PA-, PS- or PA+, PS+ were set at 25% more or less of PA or PS (PA- = 75% PA, PA+ = 125% PA, PS- = 75% PS, PS+ = 125% PS). Each level lasted at least 20 min. To demonstrate the patient-ventilator interaction, the neural respiratory drive, respiratory muscle effort, flow signal, and airway pressure were simultaneously monitored. RESULTS: The expiratory cycle delay (time between the termination of the diaphragm electromyogram [EMGdi] signal and the end of the inspiratory flow) progressively increased with increasing assist level in both modes. However, compared with PSV, the expiratory cycle delay was significantly longer in each assist level during noninvasive PAV. The runaway phenomenon was observed in PA+. The time between the peak EMGdi signal and the maximum value of the flow signal and the time difference between the peak EMGdi signal and the maximum value of inspiratory pressure were significantly increased with the increasing assist level of PAV. CONCLUSIONS: The expiratory cycle delay of noninvasive PAV was significantly longer than that of noninvasive PSV in the subjects with COPD with respiratory failure. During the levels of PAV, the lag time between neural respiratory drive and airway pressurization was significantly increased and the "runaway" phenomenon may be observed. pubtype: Academic Journal doctype: research tables/charts randomized controlled trial Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
|---|