Document Detail

Patient-ventilator interaction during synchronized intermittent mandatory ventilation. Effects of flow triggering.
MedLine Citation:
PMID:  7812537     Owner:  NLM     Status:  MEDLINE    
Synchronized intermittent mandatory ventilation (SIMV) intermixes assisted and spontaneous breaths. Its ability as a weaning technique has been questioned on the basis that patients show little adaptation to ventilator assistance. We studied inspiratory effort and patient-ventilator interaction at different levels (SIMV, 100, 50, and 0%) of flow-triggered SIMV versus pressure-triggered SIMV in patients during the weaning period. The two triggering systems were evaluated during constant flow and constant pressure mandatory SIMV breaths. Inspiratory effort was estimated as the esophageal pressure time product (PTP) per breath (PTP/b) and per minute (PTP/min). The PTP/b and PTP/min of both mandatory and spontaneous breaths were significantly lower during flow triggering than during pressure triggering SIMV, irrespective of the ventilatory mode. During pressure-triggered SIMV PTP/b and PTP/min were identical for mandatory and spontaneous breaths, whereas during flow-triggered SIMV PTP/b and PTP/min were significantly lower for mandatory than for spontaneous breaths. This difference was greatest when flow triggering and constant pressure ventilation were associated. These data show that flow triggering reduces inspiratory effort during both mandatory and spontaneous SIMV breaths and obtains a better patient-ventilator interaction.
R Giuliani; L Mascia; F Recchia; A Caracciolo; T Fiore; V M Ranieri
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Publication Detail:
Type:  Comparative Study; Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  American journal of respiratory and critical care medicine     Volume:  151     ISSN:  1073-449X     ISO Abbreviation:  Am. J. Respir. Crit. Care Med.     Publication Date:  1995 Jan 
Date Detail:
Created Date:  1995-02-09     Completed Date:  1995-02-09     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  9421642     Medline TA:  Am J Respir Crit Care Med     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  1-9     Citation Subset:  AIM; IM    
Istituto di Anestesiologia e Rianimazione, Università di Bari, Italy.
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MeSH Terms
Acute Disease
Intermittent Positive-Pressure Breathing / methods*,  statistics & numerical data
Intermittent Positive-Pressure Ventilation / methods*,  statistics & numerical data
Middle Aged
Respiratory Function Tests / statistics & numerical data
Respiratory Insufficiency / physiopathology,  therapy
Respiratory Muscles / physiopathology
Ventilator Weaning

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