RT Book, Section
A1 Brochard, Laurent J.
A1 Lellouche, Francois
A2 Tobin, Martin J.
SR Print(0)
ID 57062930
T1 Chapter 8. Pressure-Support Ventilation
T2 Principles and Practice of Mechanical Ventilation, 3e
YR 2013
FD 2013
PB The McGraw-Hill Companies
PP New York, NY
SN 978-0-07-173626-8
LK accessmedicine.mhmedical.com/content.aspx?aid=57062930
RD 2024/04/25
AB Pressure-support  ventilation  (PSV)  is  a  mode  of  partial  ventilator  support.  Such  modes  are  widely  used  in  intensive  care  units  (ICUs)  because  most  ventilated  patients  (unless  deeply  sedated)  have  preserved  respiratory  drive.  The  use  of  these  modes  helps  to  reduce  need  for  sedation,  an  important  issue  in  the  ICU,1,2  and  potentially  prevents  disuse  atrophy  of  the  respiratory  muscles  that  can  result  from  controlled  ventilation.3,4  This  preventive  effect  has  been  shown  experimentally  with  different  modes  of  partial  support.3,5  Finally,  partial  support  may  facilitate  both  the  screening  process  for  detecting  patients  able  to  breathe  spontaneously  as  well  as  the  weaning  of  patients  with  prolonged  or  difficult  weaning.6  An  ideal  mode  of  partial  support  should  be  able  to  supply  both  full  ventilator  support  and  optimal  support  during  weaning;  optimize  patient–ventilator  synchronization  and  comfort  while  reducing  the  need  for  sedation  and  the  risk  of  cardiovascular  consequences;  and,  if  possible,  facilitate  or  reduce  the  duration  of  the  weaning.  PSV  meets  several  of  these  requirements,  at  least  partially,  as  discussed  in  this  chapter.  PSV  also  has  limitations,  which  are  delineated.  One  important  limitation  is  that  overassistance  of  the  patient  can  be  easily  reached  and  improvement  in  the  delivery  of  the  optimal  PSV  level  continues  as  a  field  of  research.