Costa R, Spinazzola G, Cipriani F, Ferrone G, Festa O, Arcangeli A, Antonelli M, Proietti R, Conti G.; Intensive Care Med. 2011 Sep;37(9):1494-500. Epub 2011 Jul 1.
Purpose: To compare patient–ventilator interaction during PSV and PAV+ in patients that are difficult to wean.
Results: Compared to PAV+, during PSV trials, the mechanical inspiratory time (Tiflow) was significantly longer than patient inspiratory time (Tipat) (p < 0.05); Tipat showed a prolongation between PSV1 and PAV+, significant comparing PAV+ and PSV2 (p < 0.05). PAV+ significantly reduced delaytrexp (p < 0.001). The portion of tidal volume (VT) delivered in phase with Tipat (VTpat/VTmecc) was significantly higher during PAV+ (p < 0.01). The time of synchrony was significantly longer during PAV+ than during PSV (p < 0.001). During PSV 5 patients out of 11 showed an AI greater than 10%, whereas the AI was nil during PAV+.
Conclusion: PAV+ improves patient–ventilator interaction, significantly reducing the incidence of end-expiratory asynchrony and increasing the time of synchrony.
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