The Science Journal of the American Association for Respiratory Care

1999 OPEN FORUM Abstracts

Ventilator Management by Respiratory Therapists (RTs) during a Multicenter Randomized Trial of Non-Invasive Proportional Assist Ventilation (PAV) VS. Pressure Support Ventilation (PSV) in Acute Respiratory Failure (ARF) Pts.

P Gay MD, S Holets RRT, CCRA, D Hess PhD, D Nelson RRT, N Hill MD. Mayo Clinic-Rochester, MN; Mass Gen Hosp-Boston, MA; Rhode Island Hosp-Providence, RI

Background: We have reported that PAV and PSV modes resulted in similar intubation rates and mortality in pts with ARF (Am J Resp Crit Care 1999; 159:A14). We wished to test whether excessive effort by RTs was needed and provided to patients for the PAV vs PSV mode.

Methods: Pts with ARF were randomized to receive PAV or PSV mode and we prospectively charted both the number of times pts needed encouragement (#ENC) to continue and how many inspiratory ventilator setting changes (#IPAP) were required for optimizing each mode.

Results: There was a significantly higher %pts encouraged (p < 0.02) and more total pt encouragement episodes (p < 0.04) for PSV mode

(Mean ± SD %Pts-PSV vs PAV=44 ± 10 vs 22 ± 13; Total #ENC-PSV vs PAV= 19.5 ± 15.2 vs 7.5 ± 6.2). There was no significant difference (p > 0.15) in the #IPAP changes between the 2 modes (#IPAP-PSV vs PAV=2.8 ± 1.9 vs 5.5 ± 3.1). The #ENC for the first 6 hours is shown.

Conclusions: PAV mode required similar ventilator setting changes and less pt encouragement effort than PSV mode in this clinical trial.

Study funded by Respironics Inc. Murraysville, PA.

(See Original for Figure)

OF-99-104

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