Respiratory failure & ventilation
Pendelluft in hypoxemic patients resuming spontaneous breathing: proportional modes versus pressure support ventilation
Authors' conclusion
Pendelluft magnitude is associated with respiratory drive and inspiratory effort. Proportional modes do not prevent its occurrence in resolving ARDS compared with PSV.
Study context
- Population
- Hypoxemic patients with resolving acute respiratory distress syndrome (ARDS) resuming spontaneous breathing after controlled ventilation (> 72 h)crossover
- Participants
- 20 patients
- Comparison
- Neurally-adjusted ventilatory assist (NAVA) and PAV+ vs pressure support ventilation (PSV)
- Primary endpoint
- Pendelluft magnitude (% of lost volume from non-dependent lung region displaced to dependent region during inspiration)
- Follow-up
- 20-min per mode
Primary result
As reported in the abstract
Pendelluft magnitude
P < 0.001
Further findings
Inspiratory effort (PTPmin) — NAVA and PAV + vs PSV · for both comparisons
P < 0.001
Median, cm H2O
| Outcome | NAVA | PAV + | PSV | β | P value |
|---|---|---|---|---|---|
| Respiratory drive (ΔPes 100 ms)NAVA and PAV + vs PSV · for both comparisons | −2.8 (IQR −3.8–-1.9) | −3.6 (IQR −3.9–-2.4) | −2.1 (IQR −2.5–-1.1) | P < 0.001 | |
| Pendelluft vs PSV adjusted for PTPmin / driveNAVA vs PSV · adjusted for PTPmin | 2.606 | P = 0.010 | |||
| Pendelluft vs PSV adjusted for PTPmin / drivePAV + vs PSV · adjusted for PTPmin | 3.360 | P = 0.004 | |||
| Pendelluft vs PSV adjusted for PTPmin / drivePAV + vs PSV · adjusted for respiratory drive; only PAV + remained higher | 2.643 | P = 0.009 |
Association of pendelluft with drive and effort (mixed-effects models)
- Respiratory drive, β (independent of mode)
- −2.771
- Inspiratory effort, β (independent of mode)
- 0.026
- p < 0.001 for both
Original publication
Pendelluft in hypoxemic patients resuming spontaneous breathing: proportional modes versus pressure support ventilation. Ann Intensive Care. Published 20 December 2023. doi:10.
Composed by AI from the published abstract and checked against it. How Briefs are made →