Ventilation pressure support

This mode is similar to the CPAP mode with the exception that during the inspiration the ventilator attempts to maintain the patient s airway pressure at a level above PEEP, called pressure support level. In fact, CPAP maybe considered a special case of pressure support ventilation in which the support level... 

Banner MJ, Kirby RR, MacIntyre NR. Patient and ventilator work of breathing and ventilatory muscle loads at different levels of pressure support ventilation. Chest 1991 100 531-533. 

Esteban A, Alia I, Gordo F, et al. Extubation outcome after spontaneous breathing trials with T-tube or pressure support ventilation. The Spanish Lung Failure Collaborative Group. Am J Respir Crit Care Med 1997 156(2 pt 1) 459 5. 

Harding J, Kemper M, Weissman C. Pressure support ventilation attenuates the cardiopulmonary response to an acute increase in oxygen demand. Chest 1995 107 1665-1672. 

Nava S, Ambrosino N, Rubini F, et al. Effects of nasal pressure support ventilation and external PEEP on diaphragmatic activity in patients with severe stable COPD. Chest 1993 103 143—150. Vitacca M, Naza S, Confalonieri M, et al. The appropriate setting of noninvasive pressure support ventilation in stable COPD patients. Chest 2000 118 1286-1293. 

Meecham Jones DJ, Paul EA, Jones PW, et al. Nasal pressure support ventilation plus oxygen compared with oxygen therapy alone in hypercapnic COPD. Am J Respir Crit Care Med 1995 152(2) 538-544. 

In pressure ventilation, most ventilators cycle from inspiration to expiration when inspiratory flow decreases to a predetermined percent of its peak flow or when a preset inspiratory time is reached. It has become increasingly clear that cycling plays an important role in assuring patient-ventilator synchrony (11). This has been quite well studied in pressure support ventilation and several authors have shown that a fixed cycle value can lead to premature cycling in patients with restrictive diseases and delayed cycling in those with obstructive disease (12,13). 

Bonmarchand G, Chevron V, Menard JF, et al. Effects of pressure ramp slope values on the wrak of breathing during pressure support ventilation in restrictive patients. Crit Care Med 1999 27 670-671. 

Restrick LJ, Fox NC, Braid G, et al. Comparison of nasal pressure support ventilation with nasal intermittent positive pressure ventilation in patients with nocturnal hypoventilation. Eur... 

Yamada Y, Du H. Analysis of the mechanisms of expiratory asynchrony in pressure support ventilation a mathematical ap noach. J Appl Physiol 2000 88 2143-2150. 

Tassaux D, Michotte J, Gainnier M, et al. Expiratory trigger setting in pressure support ventilation from mathematical model to bedside. Crit Care Med 2004 32 1844-1850. 

Lofaso F, Brochard L, Touchard D, et al. Evaluation of carbon dioxide rebreathing during pressure support ventilation with airway management system (BiPAP) devices. Chest 1995 108 772-778. 

Questionnaire NPSV, nasal pressure support ventilation. Source Modified from Ref. 18. 

Gonzalez J, Sharshar T, Hart N, et al. Air leaks during mechanical ventilation as a cause of persistent hypercapnia in neuromuscular distnders. Intensive Care Med 2003 29 596-602. Schettino GP, Tucci MR, Sousa R, et al. Mask mechanics and leak djmamics during noninvasive pressure support ventilation a bench study. Intensive Care Med 2001 27 1887-1891. 

Fauroux B, Boule M, Lofaso F, et al. Chest physiotherapy in cystic fibrosis improved tolerance with nasal pressure support ventilation. Pediatrics 1999 103(3) E32. 

If there is a developing respiratory failure of the type 1 variety due to acute Itmg injury and the gradual infiltration of the alveoli, pressure support ventilation may be required. This is normally provided in an intensive care unit as part of a protective ventilation strategy used in the management of ARDS (see Chap. 9). 

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