Proportional Assist Ventilation (PAV) in Early Stage of Critically Ill Patients

Launched by ALTHAIA XARXA ASSISTENCIAL UNIVERSITÀRIA DE MANRESA · Sep 16, 2010

Keywords

ClinConnect Summary

The goal of this proposal is to apply PAV+ as routine ventilatory mode in the early stage of critically ill patients, taking advantages of spontaneous breathing and better patient-ventilator interaction.

The standard treatment in patients with acute respiratory failure is mechanical ventilation in control-mode for the first days of acute illness. This procedure is usually associated with patient-ventilator dyssynchrony, higher needs of sedation and/or relaxation, muscle atrophy, etc. PAV + is a new ventilatory mode that applies pressure in proportion to spontaneous patient inspiratory effo...

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Eligibility criteria

• Inclusion Criteria:
• • Patients 18 years of age or older
• • Anticipated MV \> 24 hours
• • Availability of informed consent from patient or next of kin
• * Ventilation parameters measured under PAV+ 80% gain:
• • PaO2/FiO2 \>100 RPAV \<10 cm H2O/l/s CPAV \> 30 ml/cm H2O WOBTOT \<1.5 J/l VE \<18 l/min
• Exclusion Criteria:
• • Patients on moribund state or with life-sustaining therapy withholding decision.
• • Patients with unstable respiratory/hemodynamic state, PaO2/FiO2 \<100, Dopamine \>15 microg/Kg/min or epinephrine \>0.1 microg/kg/min.
• • Pregnancy.
• • Air leak.
• • Patients needing deep sedation or muscle paralysis
• • Patients needing hyperventilation (brain trauma).
• • Patients with severe muscle weakness.
• • Recruitment maneuvers or prone position.