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Proportional assist ventilation.

S Grasso1, V M Ranieri

  • 1Unità Operativa di Terapia Intensiva, Azienda Ospedaliera Di Venere-Giovanni XXIII, Ospedale Di Venere, Bari, Italy. grassos@libero.it

Respiratory Care Clinics of North America
|August 23, 2001
PubMed
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Proportional Assist Ventilation (PAV) aims to improve breathing support by matching ventilator pressure to patient effort. Continuous adaptation to respiratory system changes is crucial for preventing patient-ventilator asynchrony.

Area of Science:

  • Mechanical Ventilation
  • Respiratory Physiology

Background:

  • Partial ventilatory support aids patients with inadequate alveolar ventilation.
  • Proportional Assist Ventilation (PAV) adjusts ventilator pressure proportionally to patient effort, theoretically enhancing neuro-ventilatory coupling.

Purpose of the Study:

  • To highlight the challenge of changing respiratory system impedance in mechanically ventilated patients.
  • To propose continuous, automatic adaptation of PAV to respiratory mechanics for optimal performance.

Main Methods:

  • The study discusses the theoretical underpinnings of PAV.
  • It identifies patient-ventilator asynchrony as a key issue arising from impedance changes.
  • It suggests noninvasive measurement of total elastance and resistance for adaptation.

Related Experiment Videos

Main Results:

  • PAV aims to make the ventilator an extension of the patient's respiratory muscles.
  • Changes in respiratory system impedance can disrupt the match between ventilator output and patient demand.
  • This mismatch can lead to patient-ventilator asynchrony.

Conclusions:

  • PAV requires continuous adaptation to the patient's respiratory system mechanics.
  • Noninvasive assessment of elastance and resistance is proposed for this adaptation.
  • Optimizing PAV necessitates addressing dynamic changes in respiratory impedance.