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Efficacy of pressure support in compensating for apparatus work
A D Bersten1, A J Rutten, A E Vedig
1Department of Anaesthesia and Intensive Care, Flinders Medical Centre, Adelaide, South Australia.
Anaesthesia and Intensive Care
|February 1, 1993
Summary
Pressure support ventilation can reduce the work of breathing for patients on mechanical ventilation. The required pressure support level depends on breathing rate, endotracheal tube size, and ventilator type.
Area of Science:
- Mechanical Ventilation
- Respiratory Physiology
- Critical Care Medicine
Background:
- Mechanical ventilation is essential for patients with respiratory failure.
- Endotracheal tubes and ventilator circuits increase the work of breathing.
- Respiratory muscle fatigue contributes to ventilator dependence.
Purpose of the Study:
- To evaluate the effectiveness of five ventilators in reducing the work of breathing.
- To assess the impact of pressure support ventilation on imposed work.
- To determine factors influencing the work of breathing during mechanical ventilation.
Main Methods:
- A spontaneous breathing model was used to measure apparatus work.
- Five ventilators (Servo 900-C, Puritan Bennett 7200a, Engstrom Erica, Drager EV-A, Hamilton Veolar) were tested.
- Varying endotracheal tube sizes, inspiratory flow rates, and pressure support levels were applied.
Main Results:
- Apparatus work increased with higher inspiratory flow rates and smaller endotracheal tube sizes.
- The Servo 900-C and Puritan Bennett 7200a ventilators showed the lowest apparatus work.
- Pressure support significantly reduced apparatus work in a curvilinear manner.
Conclusions:
- Pressure support ventilation can effectively compensate for the added work of breathing.
- The optimal pressure support level is influenced by inspiratory flow rate, endotracheal tube size, and ventilator model.
- Understanding these factors is crucial for managing ventilator-dependent patients.