{"id":335,"date":"2024-12-12T17:19:29","date_gmt":"2024-12-12T17:19:29","guid":{"rendered":"https:\/\/perfusfind.com\/ic\/?p=335"},"modified":"2024-12-22T20:28:55","modified_gmt":"2024-12-22T20:28:55","slug":"pressure-support-patient-effort-and-tidal-volume-a-conceptual-model-for-a-non-linear-interaction","status":"publish","type":"post","link":"https:\/\/perfusfind.com\/ic\/index.php\/2024\/12\/12\/pressure-support-patient-effort-and-tidal-volume-a-conceptual-model-for-a-non-linear-interaction\/","title":{"rendered":"Pressure support, patient effort and tidal volume: a conceptual model for a non linear interaction"},"content":{"rendered":"
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Abstract<\/h2>\n
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Pressure support ventilation (PSV) is a form of assisted ventilation which has become frequently used, with the aim of partially unloading the patient\u2019s inspiratory muscles. Both under- and over-assistance should be avoided to target a lung- and diaphragm- protective ventilation. Herein, we propose a conceptual model, supported by actual data, to describe how patient and ventilator share the generation of tidal volume (Vt) in PSV and how respiratory system compliance (Crs) affects this interaction. We describe the presence of a patient-specific range of PSV levels, within which the inspiratory effort (Pmus) is modulated, keeping Vt relatively steady on a desired value (Vttarget<\/sub>). This range of assistance may be considered the \u201cadequate PSV assistance\u201d required by the patient, while higher and lower levels may result in over- and under-assistance respectively. As we also show, the determinants of over- and under- assistance borders depend on the combination of Crs and the inspiratory effort which the patient is able to sustain over a period of time. These concepts can be applied at the bedside to understand if the level of assistance is adequate to patient\u2019s demand, focusing on the variation of relevant parameters (Vt, Pmus and pressure-muscle-index) as patient reaction to a change in the level of assistance.<\/p>\n<\/div>\n<\/div>\n<\/section>\n

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ACCESS FULL ARTICLE HERE<\/strong><\/a><\/p>\n

Open Access<\/b>\u00a0This article is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License, which permits any non-commercial use, sharing, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if you modified the licensed material. You do not have permission under this licence to share adapted material derived from this article or parts of it. The images or other third party material in this article are included in the article\u2019s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article\u2019s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit\u00a0http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/<\/a>.<\/p>\n","protected":false},"excerpt":{"rendered":"

Abstract Pressure support ventilation (PSV) is a form of assisted ventilation which has become frequently used, with the aim of partially unloading the patient\u2019s inspiratory muscles. Both under- and over-assistance should be avoided to target a lung- and diaphragm- protective ventilation. Herein, we propose a conceptual model, supported by actual data, to describe how patient […]<\/p>\n","protected":false},"author":1,"featured_media":347,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"site-sidebar-layout":"default","site-content-layout":"","ast-site-content-layout":"default","site-content-style":"default","site-sidebar-style":"default","ast-global-header-display":"","ast-banner-title-visibility":"","ast-main-header-display":"","ast-hfb-above-header-display":"","ast-hfb-below-header-display":"","ast-hfb-mobile-header-display":"","site-post-title":"","ast-breadcrumbs-content":"","ast-featured-img":"","footer-sml-layout":"","theme-transparent-header-meta":"default","adv-header-id-meta":"","stick-header-meta":"","header-above-stick-meta":"","header-main-stick-meta":"","header-below-stick-meta":"","astra-migrate-meta-layouts":"set","ast-page-background-enabled":"default","ast-page-background-meta":{"desktop":{"background-color":"var(--ast-global-color-4)","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""},"tablet":{"background-color":"","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""},"mobile":{"background-color":"","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""}},"ast-content-background-meta":{"desktop":{"background-color":"var(--ast-global-color-5)","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""},"tablet":{"background-color":"var(--ast-global-color-5)","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""},"mobile":{"background-color":"var(--ast-global-color-5)","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""}},"footnotes":""},"categories":[6,66],"tags":[97,96,95],"class_list":["post-335","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-mechanical-ventilation","category-pharmacological-insights-in-critical-care","tag-acute-respiratory-failure","tag-invasive-mechanical-ventilation","tag-pressure-support-ventilation"],"yoast_head":"\nPressure support, patient effort and tidal volume: a conceptual model for a non linear interaction - Perfusfind Intensive Care<\/title>\n<meta name=\"description\" content=\"Pressure support ventilation (PSV) is a form of assisted ventilation which has become frequently used, with the aim of partially unloading the patient\u2019s inspiratory muscles. 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Both under- and over-assistance should be avoided to target a lung- and diaphragm- protective ventilation. Herein, we propose a conceptual model, supported by actual data, to describe how patient…","_links":{"self":[{"href":"https:\/\/perfusfind.com\/ic\/index.php\/wp-json\/wp\/v2\/posts\/335","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/perfusfind.com\/ic\/index.php\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/perfusfind.com\/ic\/index.php\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/perfusfind.com\/ic\/index.php\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/perfusfind.com\/ic\/index.php\/wp-json\/wp\/v2\/comments?post=335"}],"version-history":[{"count":1,"href":"https:\/\/perfusfind.com\/ic\/index.php\/wp-json\/wp\/v2\/posts\/335\/revisions"}],"predecessor-version":[{"id":351,"href":"https:\/\/perfusfind.com\/ic\/index.php\/wp-json\/wp\/v2\/posts\/335\/revisions\/351"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/perfusfind.com\/ic\/index.php\/wp-json\/wp\/v2\/media\/347"}],"wp:attachment":[{"href":"https:\/\/perfusfind.com\/ic\/index.php\/wp-json\/wp\/v2\/media?parent=335"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/perfusfind.com\/ic\/index.php\/wp-json\/wp\/v2\/categories?post=335"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/perfusfind.com\/ic\/index.php\/wp-json\/wp\/v2\/tags?post=335"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}