Pressure-targeted ventilation

PAOpeak and the end-inspiratory PAOplateau. In contrast, in pressure-targeted ventilation, the set PAO limit coupled with a rising intrinsic PEEP level will decrease APAO and the delivered VT. 

There have been several inconclusive studies of patients with CRF comparing volume-targeted with pressure-targeted ventilation (9,10). Given equal efficacy, clinicians can feel comfortable to begin ventilation with the method of their choice. If patients fail to respond or are noncompliant, the other method should be tried. This is especially important for NIV where poor efficacy could lead to the need for a tracheostomy. 

The development of intrinsic PEEP will have different effects on pressure-targeted versus flow- or volume-targeted ventilation. In flow- or volume-targeted ventilation, the constant delivered volume in the setting of a rising intrinsic PEEP will increase both the... 

Ventilators of new generation also allow the clinician to choose either a volume-targeted or pressure-targeted approach. The use of volume-targeted approach is guaranteed by a minimum minute volume, even as the patient s compliance and resistance are changing. During CMV mode and... 

Earlier experiments indicate clearly that a lowered sound pressure level can be an effective measure to reduce the inconvenience reactions due to a ventilation noise, provided that it is targeted at the most critical frequency range from the point of view of influence or that the measure results in a general lowering over the entire spectral range of the ventilation noise. 

Figure 1 Airway pressure, flow and volume tracings, over time, depicting the five basic breaths available in most modem ventilators. Breaths are classified by their trigger, target/limit, and cycle variables. Abbreviation fl, inspiratory time. Source From Ref- 74.

Yang LY, Huang YC, MacIntyre NR. Patient-ventilator synchrony during pressure versus flow targeted small tidal volume assisted ventilation. J Crit Care 2007 22 252-257. 

In the first condition inspiratory time can be increased by augmenting the tidal volume and decreasing inspiratoiy flow in the volume-controlled modes of mechanical ventilation (17). In pressure-support mode, inspiratoiy time can be prolonged by the delay in reaching the target inspiratoiy flow as a consequence of the intentional air leak (19). 

Three usually seen airflow, including sinusoidal, square, and descending wave, in mechanical ventilation are modeled as the inspiratory flow pattern during CMV mode and volume-targeted mechanical ventilation in this paper. Instead of optimizing the pressure profile, the airflows waveforms will be optimized in current study through the optimal respiratory control model. 

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