Comparison of Effectiveness of Proportional Assist Ventilation and Pressure Support Ventilation for Weaning Adult Patients from Prolonged Mechanical Ventilation: A Randomized Controlled Trial

Pi-Hua Lin ； Chiu-Fan Chen ； David Lin Lee

《胸腔醫學》 36卷2期 (2021/06) Pp. 81-94

摘要

Background: Proportional assist ventilation with load-adjustable gain factors (PAV+) is a promising mode with better patient synchrony and weaning advantages. This study aimed to compare the effectiveness of PAV+ and pressure support ventilation (PSV) for weaning adult patients from prolonged mechanical ventilation (PMV). Methods: Patients with PMV were recruited for this prospective trial. Patients were randomly assigned to receive PAV+ or PSV as a weaning mode. Weaning outcomes and mortality were evaluated. Results: A total of 36 patients completed the study (18 in the PAV+ group and 18 in the PSV group). The peak inspiratory pressure and tidal volume initially were significantly lower in the PAV+ group than in the PSV group. Both peak inspiratory pressure and tidal volume decreased during the weaning process in both groups, and the PAV+ group showed a smaller tidal volume change. Outcome analysis showed that the PAV+ group possibly had better results in the 28-day weaning success rate, weaning duration, and hospital mortality than the PSV group, but significance was not achieved. Conclusion: This study proved the effectiveness of the PAV+ mode for weaning patients with PMV. PAV+ may be a potential mode for weaning patients with PMV in the future.

關鍵字

pressure support ventilation ； prolonged mechanical ventilation ； proportional assist ventilation ； respiratory failure ； weaning