Advertisement

Proportional Assist Ventilation (PAV): Physiologic Rationale and Clinical Advantages

  • M. Ranieri
  • S. Grasso
  • L. Mascia
  • R. Giuliani

Abstract

Considerable interest has recently developed in pressure-assisted methods of ventilatory support. Two of these have been so far described, pressure support ventilation (PSV) (1,2) and the more recent proportional assist ventilation (PAV) (3, 4). The intent of these methods is to assist each spontaneous breath by providing positive pressure at the airway (Paw) during the period of spontaneous inspiration. During PSV and PAV, Paw is the ventilator controlled variable while inspiratory flow and tidal volume are determined by the combined action of the pressure generated by the respiratory muscles (Pmus) the pressure generated by the ventilator (Pappl). Because the ventilatory consequences of these methods are essentially the result of patient-ventilator interaction, the patient retains considerable control over breathing pattern, flow pattern and ventilation, and this is expected to result in greater patient comfort (5).

Keywords

Dead Space Pressure Support Ventilation Inspiratory Flow Ventilatory Requirement Piston Chamber 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. 1.
    Brochard L, Harf A, Lorino H, Lemaire F (1989) Inspiratory pressure support prevents diaphragmatic fatigue during weaning from mechanical ventilation. Am Rev Respir Dis 139:513–521PubMedCrossRefGoogle Scholar
  2. 2.
    Macintyre NR, Leatherman NE (1990) Ventilatory muscle loads and the frequency-tidal volume pattern during inspiratory pressure-assisted (pressure supported) ventilation. Am Rev Respir Dis 141:327–331PubMedGoogle Scholar
  3. 3.
    Younes M (1992) Proportional assist ventilation, a new approach to ventilatory support. Am Rev Respir Dis 145:114–120PubMedCrossRefGoogle Scholar
  4. 4.
    Younes M, Puddy A, Roberts D, Light RB, Quesada A, Taylor K, Oppenheimer L, Cramp H (1992) Proportional assist ventilation. Results of an initial clinical trial. Am Rev Respir Dis 145:121–129PubMedCrossRefGoogle Scholar
  5. 5.
    Brochard L (1994) Pressure support ventilation. In: Tobin MJ (ed) Principles and practice of mechanical ventilation. McGraw-Hill, New York, pp 239–257Google Scholar
  6. 6.
    Younes M (1991) Proportional assist ventilation and pressure support ventilation: similarities and differences. In Marini JJ, Roussos C (eds) Ventilatory failure. Springer, Berlin Heidelberg New York, pp 361–380Google Scholar
  7. 7.
    Mascia L, Grasso S, GiuHani R, Caracciolo A, Brienza A, Bruno F, Fiore T, Ranieri VM (1995) Patient-ventilator interaction following sudden changes in respiratory drive: pressure support ventilation (PSV) vs proportional assist ventilation (PAV). Am J Respir Crit Care Med (in press)Google Scholar
  8. 8.
    Grasso S, Mascia L, Giuliani R, Lagioia V, Spagnolo A, Pughese V, De Tulho R, Ranieri VM (1995) Ventilatory support in COPD during Proportional Assist Ventilation (PAV): Effects on breathing pattern and inspiratory effort. Am J Respir Crit Care Med (in press)Google Scholar

Copyright information

© Springer-Verlag Italia, Milano 1996

Authors and Affiliations

  • M. Ranieri
  • S. Grasso
  • L. Mascia
  • R. Giuliani

There are no affiliations available

Personalised recommendations