Proportional Assist Ventilation and Pressure Support Ventilation: Similarities and Differences

Younes, Magdy

doi:10.1007/978-3-642-84554-3_21

Cited by 27 publications

(48 citation statements)

References 27 publications

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“…When the duration of the negative pressure in the box is 0.25 s, this models the situation where the patient triggers the positive pressure pump but there is no subsequent patient effort during the inspiratory phase. When the negative pressure in the box lasts for 1.5 s, there is an almost complete overlap between the duration of patient effort and ventilator tI [10].…”

Section: The Effects Of Patient Effortmentioning

confidence: 99%

“…When the patient makes an inspiratory effort of sufficient duration to just trigger the ventilator, it would be expected that the resulting breath should have the same VT as an untriggered breath for the Companion 2801 and the Nippy [10]. The minute volume should, therefore, increase in direct proportion to the rise in f' R, i.e.…”

Section: The Effects Of Patient Effortmentioning

confidence: 99%

“…For a pressure preset ventilator, the effective inspiratory driving pressure is the pressure difference across the lungs, i.e. the difference between the airway pressure and the pleural pressure [10] (or box pressure in the present model). For triggering plus prolonged patient effort, therefore, the minute volume would be expected to increase due both to the increase in f'R and to an increase in VT secondary to this rise in effective driving pressure.…”

Section: The Effects Of Patient Effortmentioning

confidence: 99%

“…Theoretical models of some of these have been examined [10], and there have been some clinical studies comparing different ventilators [11][12][13]. However, to our knowledge, there are few published data comparing the bench performance of different ventilators used for NiIPPV.…”

mentioning

confidence: 99%

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A laboratory comparison of four positive pressure ventilators used in the home

Smith¹,

Shneerson²

1996

Eur Respir J

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A A l la ab bo or ra at to or ry y c co om mp pa ar ri is so on n o of f f fo ou ur r p po os si it ti iv ve e p pr re es ss su ur re e v ve en nt ti il la at to or rs s u us se ed d i in n t th he e h ho om me e I.E. Smith, J.M. Shneerson These results show that distinct brands of ventilator respond to changes in the patient and patient circuit in different ways, which are not always predictable from a simple description of their operating principles. This should be borne in mind when choosing a positive pressure ventilator for noninvasive ventilation.

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Section: The Effects Of Patient Effortmentioning

confidence: 99%

Section: The Effects Of Patient Effortmentioning

confidence: 99%

Section: The Effects Of Patient Effortmentioning

confidence: 99%

mentioning

confidence: 99%

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A laboratory comparison of four positive pressure ventilators used in the home

Smith¹,

Shneerson²

1996

Eur Respir J

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“…Air leaks are common during NIPPV and may lead to inadequate treatment [6]. A pressure preset ventilator should respond to increased patient effort during a breath with increased flow and a greater tidal volume (VT) [7], in contrast to volume preset ventilators where VT is fixed. The addition of expiratory positive airway pressure (EPAP) to the ventilator circuit may be useful in patients with dynamic hyperinflation, as it reduces the effort needed to trigger the ventilator [8,9].…”

mentioning

confidence: 99%

Functional differences in bi-level pressure preset ventilators

Highcock¹,

Shneerson²,

Smith³

2001

Eur Respir J

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The ventilators tested were; BiPAP ST30 (Respironics); Nippy2 (BzD Electrical); Quantum PSV (Healthdyne); and Sullivan VPAP II ST (Resmed). A patient simulator was used to determine the sensitivity of the triggering mechanisms and the responses to a leak within the patient circuit, and to changes in patient effort.Significant differences (pv0.05) between the devices were seen in the trigger delay time and inspiratory trigger pressure. When a leak was introduced into the patient circuit, the fall in tidal volume (VT) was less than ten per cent for each ventilator. The addition of patient effort produced a number of changes in the ventilation delivered. Patient efforts of 0.25 s induced a variable fall in VT. An increase in VT was seen with some ventilators with patient efforts of 1 s but the effect was variable. Trigger failures and subsequent falls in minute volume were seen with the BiPAP and the Nippy2 at the highest respiratory frequency.Differences in the responses of the ventilators are demonstrated that may influence the selection of a ventilator, particularly in the treatment of breathless patients with ventilatory failure.

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