Advanced Patient Synchrony and Proportional Assist Ventilation – The cost of providing care to critically ill patients in the US consumes roughly 1% of the gross national product. Contributing to this economic burden are patients admitted to the ICU requiring mechanical ventilation and the complications resulting from ventilator dependency. In fact, 50% of all ICU patients receive mechanical ventilation.
To ensure adequate ventilation, a mechanical ventilator must be synchronized to a
patient’s individual respiratory needs. And yet, 10% to 25% of patients experience
patient-ventilator asynchrony, a mismatch between the patient and ventilatory inspiratory time, flow and expiratory time. Asynchrony can occur at the start of a breath
(trigger asynchrony), during the breath (flow asynchrony) or at the end of a breath
(cycle or termination asynchrony). Proportional assist ventilation (PAV) relies on
noninvasive measurements of patient respiratory parameters to optimize patientventilator synchrony. In this article, John Davies discusses the features of PAV, how it
may be used to improve patient-ventilator synchrony, and some of its limitations in
the clinical setting.
2.0 Free CEUs for Respiratory Therapists