Document Detail


Pressure Support Ventilation Advisory System Provides Valid Recommendations for Setting Ventilator.
MedLine Citation:
PMID:  21235833     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
Background: Pressure support ventilation (PSV) should be applied so that the inspiratory muscles are unloaded appropriately. We developed a computerized PSV advisory system that assesses the load on the inspiratory muscles to spontaneously inhale, reflected by work of breathing per minute that is measured automatically and non-invasively, and tolerance for that load, reflected by spontaneous breathing frequency and tidal volume, in a fuzzy logic algorithm that provides recommendations for setting PSV. This may be referred to as a load and tolerance strategy for determining PSV. The purpose of this clinical validation study was to compare recommendations from the PSV advisory system to the recommendations of experienced critical care registered respiratory therapists (RRT) for setting PSV on patients with respiratory failure. Methods: Adults (n = 76) in a university medical center surgical intensive care unit receiving PSV had data from a combined pressure/flow sensor, positioned between the endotracheal tube and Y-piece of the ventilator breathing circuit, directed to the PSV advisory system. Recommendations from the system for increasing, maintaining, or decreasing PSV were compared to recommendations made by RRTs at the bedside. Results: There were no significant differences in the recommendations by the advisory system (n = 109) compared to those of RRTs to increase, maintain, or decrease PSV (p > 0.05). RRTs agreed with 91% of all recommendations (K = 0.85, p < 0.001). The advisory system was very good at predicting RRTs decisions (r² = 0.87, p < 0.02) in setting PSV. Conclusions: A load and tolerance strategyin a computerized PSV advisory system provided valid recommendations for setting PSV to unload the inspiratory muscles that were essentially the same as the recommendations from experienced, critical care RRTs. The PSV advisory system operates continuously and automatically and may be useful in clinical environments where experts may not always be available.
Authors:
Steven Bonett; Michael J Banner; Neil R Euliano; Carl W Peters; A Joseph Layon; Andrea Gabrielli
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2010-11-16
Journal Detail:
Title:  Respiratory care     Volume:  -     ISSN:  0020-1324     ISO Abbreviation:  -     Publication Date:  2010 Nov 
Date Detail:
Created Date:  2011-1-17     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  7510357     Medline TA:  Respir Care     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
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