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Ventilatory Modes: Pressure Support Ventilation and Other Ventilatory Options

  • Pasquale Buonanno
  • Maria VargasEmail author
  • Giuseppe Servillo
Chapter

Abstract

Pressure support ventilation is a pressure-targeted, flow-cycled, mode of ventilation in which each breath must be patient-triggered (Fig. 22.1). Thus, respiratory rate is determined by the patient; the ventilator is able to sense patient’s respiratory effort which is immediately supported by a pressure set by the operator [1]. The time of pressurization can be determined and it is defined Rise Time. At the beginning of inspiration, the difference of pressure between the ventilator and the lung is highest so the inspiratory flow reaches its peak; as the air is pushed in the alveoli, the pressure of respiratory system of patient increases and the difference of pressure between the ventilator and the patient decreases so the flow starts to linearly decline. The pressure support stops when the inspiratory flow decreases under a value (called expiratory trigger) set by the operator, so the inspiratory time is variable and flow dependent. Expiratory trigger can be an absolute value (typically ranging from 2 to 6 L/min) or a percentage of the inspiratory peak flow; some ventilators fix a limit for inspiratory duration to prevent the prolongation of inspiration in case of circuit leakage. Expiration is determined by the withdrawal of pressure support so it is totally passive; a PEEP (positive end-expiratory pressure) can be set to avoid atelectasis.

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Copyright information

© Springer Nature Switzerland AG 2020

Authors and Affiliations

  • Pasquale Buonanno
    • 1
  • Maria Vargas
    • 1
    Email author
  • Giuseppe Servillo
    • 1
  1. 1.Department of Neurosciences, Reproductive and Odontostomatological SciencesUniversity of Naples “Federico II”NaplesItaly

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