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Ventilatory Modes: Pressure Support Ventilation and Other Ventilatory Options

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Book cover Ventilatory Support and Oxygen Therapy in Elder, Palliative and End-of-Life Care Patients

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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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Authors and Affiliations

  1. Department of Neurosciences, Reproductive and Odontostomatological Sciences, University of Naples “Federico II”, Naples, Italy

    Pasquale Buonanno, Maria Vargas & Giuseppe Servillo

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  1. Pasquale Buonanno
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  2. Maria Vargas
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  3. Giuseppe Servillo
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Correspondence to Maria Vargas .

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Editors and Affiliations

  1. Intensive Care Unit, Hospital General Universitario Morales Meseguer, Murcia, Spain

    Antonio M. Esquinas

  2. Geriatric and Intensive Geriatric Care, Azienda Ospedaliera S.Giuseppe Moscati, Avellino, Italy

    Nicola Vargas

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Buonanno, P., Vargas, M., Servillo, G. (2020). Ventilatory Modes: Pressure Support Ventilation and Other Ventilatory Options. In: Esquinas, A., Vargas, N. (eds) Ventilatory Support and Oxygen Therapy in Elder, Palliative and End-of-Life Care Patients . Springer, Cham. https://doi.org/10.1007/978-3-030-26664-6_22

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  • DOI: https://doi.org/10.1007/978-3-030-26664-6_22

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