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Intensive Care Medicine
Published in: Intensive Care Medicine 8/2010

01-08-2010 | Original

Influence of ventilator settings on patient–ventilator synchrony during pressure support ventilation with different interfaces

Authors: R. Costa, P. Navalesi, G. Spinazzola, G. Ferrone, A. Pellegrini, F. Cavaliere, R. Proietti, M. Antonelli, G. Conti

Published in: Intensive Care Medicine | Issue 8/2010

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Abstract

Objective

To evaluate patient–ventilator interaction during pressure support ventilation (PSV) delivered with three interfaces [endotracheal tube (ET), face mask (FM), and helmet (H)] at different pressurization times (Timepress), cycling-off flow thresholds (Trexp), and respiratory rates (RR) in a bench study, and with FM and H in a healthy volunteers study.

Design

Bench study using a mannequin connected to an active lung simulator, and human study including eight healthy volunteers.

Measurements

PSV was delivered through the three interfaces with three different RR in the bench study, and through FM and H at two different RR in the human study. The mechanical and the neural RR, Ti, Te, inspiratory trigger delay (Delaytrinsp), pressurization time, and expiratory trigger delay were randomly evaluated at various ventilator settings (Timepress/Trexp: 50%/25%, default setting; 20%/5%, slow setting; 80%/60%, fast setting).

Results

Bench study: patient–ventilator synchrony was significantly better with ET, with lower Delaytrinsp and higher time of assistance (P < 0.001); the combination Timepress/Trexp 20%/5% at RR 30 produced the worst interaction, with higher rate of wasted efforts (WE) compared with Timepress/Trexp 80%/60% (20%, 40%, and 50% of WE versus 0%, 16%, and 26% of all spontaneous breaths, with ET, FM, and H, respectively; P < 0.01). In both studies, compared with H, FM resulted in better synchrony.

Conclusion

Patient–ventilator synchrony was significantly better with ET during the bench study; in the human study, FM outperformed H.
Appendix
Available only for authorised users
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Metadata
Title
Influence of ventilator settings on patient–ventilator synchrony during pressure support ventilation with different interfaces
Authors
R. Costa
P. Navalesi
G. Spinazzola
G. Ferrone
A. Pellegrini
F. Cavaliere
R. Proietti
M. Antonelli
G. Conti
Publication date
01-08-2010
Publisher
Springer-Verlag
Published in
Intensive Care Medicine / Issue 8/2010
Print ISSN: 0342-4642
Electronic ISSN: 1432-1238
DOI
https://doi.org/10.1007/s00134-010-1915-4

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