The effect of breath termination criterion on breathing patterns and the work of breathing during pressure support ventilation

Citation
H. Tokioka et al., The effect of breath termination criterion on breathing patterns and the work of breathing during pressure support ventilation, ANESTH ANAL, 92(1), 2001, pp. 161-165
Citations number
18
Language
INGLESE
art.tipo
Article
Categorie Soggetti
Aneshtesia & Intensive Care","Medical Research Diagnosis & Treatment
Journal title
ANESTHESIA AND ANALGESIA
ISSN journal
0003-2999 → ACNP
Volume
92
Issue
1
Year of publication
2001
Pages
161 - 165
Database
ISI
SICI code
0003-2999(200101)92:1<161:TEOBTC>2.0.ZU;2-D
Abstract
With pressure support ventilation (PSV), each PSV breath is flow-cycled, an d the breath termination criterion (TC) is usually nonadjustable. When TC d oes not match the interaction between the patient's inspiratory-expiratory efforts to the opening and closing of the inspiratory and expiratory valves , patient-ventilator asynchrony may occur; and the work of breathing (WOB) may increase. Therefore, we studied the effect of TC on breathing patterns and WOE during PSV in eight patients with acute respiratory distress syndro me or acute lung injury. We studied five levels of TC during PSV-1%, 5%, 20 %, 35%, and 45% of the peak inspiratory flow. With increasing levels of TC, the tidal volume decreased and respiratory frequency increased, along with a decrease in duty cycle. WOE markedly increased with increasing levels of TC from 0.31 +/- 0.12 J/L with TC 1% to 0.51 +/- 0.11 J/L with TC 45%. Pre mature termination with double breathing occurred in one patient with TC 35 % and four patients with TC 45%. Delayed termination with a duty cycle of > 0.5 occurred in two patients with TC 1%. In conclusion, the proper adjustme nt of TC improves patient-ventilator synchrony and decreases WOE during PSV .