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New modes of mechanical ventilation: proportional assist ventilation, neurally adjusted ventilatory assist, and fractal ventilation

 

作者: Paolo Navalesi,   Roberta Costa,  

 

期刊: Current Opinion in Critical Care  (OVID Available online 2003)
卷期: Volume 9, issue 1  

页码: 51-58

 

ISSN:1070-5295

 

年代: 2003

 

出版商: OVID

 

关键词: mechanical ventilation;patient-ventilator interaction;alveolar recruitment;neuromechanical coupling;breath-to-breath variability

 

数据来源: OVID

 

摘要:

Increased knowledge of the mechanisms that determine respiratory failure has led to the development of new technologies aimed at improving ventilatory treatment. Proportional assist ventilation and neurally adjusted ventilatory assist have been designed with the goal of improving patient–ventilator interaction by matching the ventilator support with the neural output of the respiratory centers. With proportional assist ventilation, the support is continuously readjusted in proportion to the predicted inspiratory effort. Neurally adjusted ventilatory assist is an experimental mode in which the assistance is delivered in proportion to the electrical activity of the diaphragm, assessed by means of an esophageal electrode. Biologically variable (or fractal) ventilation is a new, volume-targeted, controlled ventilation mode aimed at improving oxygenation; it incorporates the breath-to-breath variability that characterizes a natural breathing pattern.

 

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