+ Site Statistics
+ Search Articles
+ PDF Full Text Service
How our service works
Request PDF Full Text
+ Follow Us
Follow on Facebook
Follow on Twitter
Follow on LinkedIn
+ Subscribe to Site Feeds
Most Shared
PDF Full Text
+ Translate
+ Recently Requested

Noninvasive proportional assist ventilation compared with noninvasive pressure support ventilation in hypercapnic acute respiratory failure



Noninvasive proportional assist ventilation compared with noninvasive pressure support ventilation in hypercapnic acute respiratory failure



Critical Care Medicine 30(2): 323-329



To compare short-term administration of noninvasive proportional assist ventilation (NIV-PAV) and pressure support ventilation (NIV-PSV). Prospective, crossover, randomized study. Medicosurgical intensive care unit in a nonteaching hospital. Twelve chronic obstructive pulmonary disease patients admitted for hypercapnic acute respiratory failure. NIV-PSV and NIV-PAV given in a randomized order after baseline evaluation in continuous positive airway pressure. Using a flow-triggering ventilator, NIV-PAV was adjusted using the runaway method and compared with NIV-PSV at similar peak inspiratory airway pressure. Flow, airway pressure, and changes in esophageal pressure were measured and the tidal volume, the patient's inspiratory work of breathing, and the esophageal pressure--time product were calculated. Arterial pH and PaCO(2) were measured and breathing comfort was assessed using a visual analogic scale. Peak inspiratory airway pressure (17 +/- 3 cm H(2)O) and tidal volume were similarly increased with the two modalities with no change in respiratory rate. The change in esophageal pressure was similarly decreased (from 20 +/- 8 cm H(2)O in continuous positive airway pressure to 12 +/- 7 in NIV-PSV and 10 +/- 5 cm H(2)O in NIV-PAV) as well as inspiratory muscle effort indexes. Arterial pH and PaCO(2) were similarly improved. Breathing comfort was significantly improved in NIV-PAV (+38 +/- 38%) but not in NIV-PSV (+11 +/- 23%). The tidal volume was more variable in NIV-PAV (89 +/- 18%) than in NIV-PSV (15 +/- 8%) and changes in tidal volume variability were significantly correlated (p =.02) with changes in breathing comfort. In chronic obstructive pulmonary disease patients with hypercapnic acute respiratory failure, NIV-PAV was able to unload inspiratory muscles similarly to NIV-PSV but may be more comfortable than NIV-PSV.

Please choose payment method:






(PDF emailed within 0-6 h: $19.90)

Accession: 046816990

Download citation: RISBibTeXText

PMID: 11889302

DOI: 10.1097/00003246-200202000-00010


Related references

Noninvasive pressure support versus proportional assist ventilation in acute respiratory failure. Intensive Care Medicine 29(7): 1126-1133, 2003

Noninvasive proportional assist ventilation for acute respiratory insufficiency. Comparison with pressure support ventilation. American Journal of Respiratory and Critical Care Medicine 164(9): 1606-1611, 2001

Comparative physiologic effects of noninvasive assist-control and pressure support ventilation in acute hypercapnic respiratory failure. Chest 111(6): 1639-1648, 1997

Noninvasive proportional assist ventilation and pressure support ventilation during arm elevation in patients with chronic respiratory failure. A preliminary, physiologic study. Respiratory Medicine 100(6): 972-979, 2005

Neurally adjusted ventilatory assist vs pressure support ventilation for noninvasive ventilation during acute respiratory failure: a crossover physiologic study. Chest 143(1): 30-36, 2013

Early Noninvasive Neurally Adjusted Ventilatory Assist Versus Noninvasive Flow-Triggered Pressure Support Ventilation in Pediatric Acute Respiratory Failure: A Physiologic Randomized Controlled Trial. Pediatric Critical Care Medicine 17(11): E487-E495, 2017

Integrated use of negative pressure ventilation and noninvasive intermittent positive pressure ventilation in patients with acute hypercapnic exacerbation of chronic respiratory failure. Chest 118(4 Suppl ): 176S, 2000

Noninvasive auto-titrating ventilation (AVAPS-AE) versus average volume-assured pressure support (AVAPS) ventilation in hypercapnic respiratory failure patients. Internal and Emergency Medicine 13(3): 359-365, 2018

Noninvasive auto-titrating ventilation (AVAPS-AE) versus average volume-assured pressure support (AVAPS) ventilation in hypercapnic respiratory failure patients: comment. Internal and Emergency Medicine 13(6): 979-980, 2018

Esogastric pressure measurement to assist noninvasive ventilation indication and settings in infants with hypercapnic respiratory failure: A pilot study. Pediatric Pulmonology 52(9): 1187-1193, 2017

Continuous positive airway pressure vs. proportional assist ventilation for noninvasive ventilation in acute cardiogenic pulmonary edema. Intensive Care Medicine 34(5): 840-846, 2008

Continuous positive airway pressure vs. proportional assist ventilation for noninvasive ventilation in acute cardiogenic pulmonary edema. Yearbook of Critical Care Medicine 2009: 45-46, 2009

Effects of noninvasive proportional assist vs pressure support ventilation on respiratory work in chronic obstructive pulmonary disease patients with hypercapnia. Zhonghua Jie He He Hu Xi Za Zhi 40(6): 450-456, 2017

Effect of Different Levels of Pressure Support and Proportional Assist Ventilation on Breathing Pattern, Work of Breathing and Gas Exchange in Mechanically Ventilated Hypercapnic Copd Patients with Acute Respiratory Failure. Respiration 70(4): 355-361, 2003

Effect of different levels of pressure support and proportional assist ventilation on breathing pattern, work of breathing and gas exchange in mechanically ventilated hypercapnic COPD patients with acute respiratory failure. Respiration; International Review of Thoracic Diseases 70(4): 355-361, 2003